Colorado Choice SilverChoice HSA 1500/30 (Colorado)

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Company Colorado Choice Health Plans
Plan Year 2014
State Colorado
Metal Tier Silver
Plan Type PPO
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Cost Sharing Benefits (In Network)

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.

Deductible (Individual) $1,500
Deductible (Family) $3,000
Coinsurance 30%
Out of Pocket Maximum (Individual) $4,000
Out of Pocket Maximum (Family) $8,000

Doctors Visits

Primary Care Visit $20 copay
Specialist Visit $40 copay
In Patient Hospital Services 30% coinsurance
Emergency Room Services $250 copay

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 30% coinsurance
Laboratory Outpatient and Professional Services 30% coinsurance
X-ray and Diagnostic Imaging 30% coinsurance


Mental / Behavioral Health $20 copay
Rehabilitative Speech Therapy 30% coinsurance
Rehabilitative Occupational & Physical Therapy 30% coinsurance
Outpatient Facility 30% coinsurance
Outpatient Surgery 30% coinsurance

Prescription Drugs

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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