Colorado Choice SilverChoice HSA 1500/30 CO

Plan Information
Company Colorado Choice Health Plans
State CO
Metal Tier Silver
Plan Type PPO

Cost Sharing Benefits

These details are for the standard Silver plan. For reduced Cost Sharing versions scroll down below

Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $1,500 Data Not Available
Deductible (Family) $3,000 Data Not Available
Coinsurance 30% Data Not Available
Out of Pocket Maximum (Individual) $4,000 Data Not Available
Out of Pocket Maximum (Family) $8,000 Data Not Available
Services In Network Out of Network
Primary Care Visit $20 copay Data Not Available
Specialist Visit $40 copay Data Not Available
In Patient Hospital Services 30% coinsurance Data Not Available
Emergency Room Services $250 copay $250 copay
Mental / Behavioral Health $20 copay Data Not Available
Imaging (CT/PET Scans, MRIs) 30% coinsurance Data Not Available
Rehabilitative Speech Therapy 30% coinsurance Data Not Available
Rehabilitative Occupational & Physical Therapy 30% coinsurance Data Not Available
Preventative Care $0 Data Not Available
Laboratory Outpatient and Professional Services 30% coinsurance Data Not Available
X-ray and Diagnostic Imaging 30% coinsurance Data Not Available
Outpatient Facility 30% coinsurance Data Not Available
Outpatient Surgery 30% coinsurance Data Not Available
Prescription Drugs In Network Out of Network
Generic Rx $15 copay
Preferred Brand Rx $40 copay
Non Preferred Brand Rx $60 copay
Specialty Drugs 0.2

Other Plans

Other plans that are available in the state.

Plan Name
SilverChoice 1750/40
SilverChoice 2000/40
SilverChoice HSA 1500/30
SilverChoice 2000/Copay
SilverChoice 3000/30
GoldChoice 1000/20
GoldChoice 1500/20
GoldChoice 500/30
BronzeChoice 5000/50
BronzeChoice 3000/50
BronzeChoice HSA 3000/50
ValueChoice 100
NC SilverChoice 1750/40
NC SilverChoice 2000/40
NC SilverChoice HAS 1500/30
NC SilverChoice 2000/Copay
NC SilverChoice 3000/30
NC GoldChoice 1000/20
NC GoldChoice 1500/20
NC GoldChoice 500/30
NC BronzeChoice 5000/50
NC BronzeChoice 3000/50
NC BronzeChoice HSA 3000/50
NC ValueChoice 100
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