Humana Humana National Preferred Silver 4250/6250 Plan GA

Plan Information
Company Humana Employers Health Plan of Georgia, Inc.
State GA
Metal Tier Silver
Plan Type POS

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) $4,250 Data Not Available
Deductible (Family) $8,500 Data Not Available
Coinsurance 20% Data Not Available
Out of Pocket Maximum (Individual) $6,250 Data Not Available
Out of Pocket Maximum (Family) $12,500 Data Not Available
Services In Network Out of Network
Primary Care Visit $35 Data Not Available
Specialist Visit $60 Data Not Available
In Patient Hospital Services 20% Coinsurance after deductible Data Not Available
Emergency Room Services 20% Coinsurance after deductible 20% coinsurance
Mental / Behavioral Health 20% coinsurance Data Not Available
Imaging (CT/PET Scans, MRIs) 20% coinsurance Data Not Available
Rehabilitative Speech Therapy 20% coinsurance Data Not Available
Rehabilitative Occupational & Physical Therapy 20% coinsurance Data Not Available
Preventative Care $0 Data Not Available
Laboratory Outpatient and Professional Services 20% coinsurance Data Not Available
X-ray and Diagnostic Imaging 20% coinsurance Data Not Available
Outpatient Facility 20% coinsurance Data Not Available
Outpatient Surgery 20% coinsurance Data Not Available
Prescription Drugs In Network Out of Network
Generic Rx $17
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx 50% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible

73% Cost Sharing Benefits

Households with incomes between 200% to 250% of FPL qualify for the following cost sharing benefits for this silver plan. To understand how cost sharing reductions work and how they work for you see our article about Obamacare Cost Sharing Reduction Discounts

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $3,250.00
Deductible (Family) $6,500.00
Out of Pocket Maximum (Individual) $4,500.00
Out of Pocket Maximum (Family) $9,000.00
Services In Network Out of Network
Primary Care Physician $35
Specialists $60
Emergency Room 20% Coinsurance after deductible
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible
Prescription Drugs In Network Out of Network
Generic Rx $17.00
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx 50% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible

87% Cost Sharing Benefits

Households with incomes between 150% to 200% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $750.00
Deductible (Family) $1,500.00
Out of Pocket Maximum (Individual) $1,350.00
Out of Pocket Maximum (Family) $2,700.00
Services In Network Out of Network
Primary Care Physician $35
Specialists $60
Emergency Room 20% Coinsurance after deductible
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible
Prescription Drugs In Network Out of Network
Generic Rx $17.00
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx 50% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible

94% Cost Sharing Benefits

Households with incomes between 138% to 150% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $500.00
Deductible (Family) $1,000.0
Out of Pocket Maximum (Individual) $750.00
Out of Pocket Maximum (Family) $1,500.00
Services In Network Out of Network
Primary Care Physician $35
Specialists $60
Emergency Room 20% Coinsurance after deductible
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible
Prescription Drugs In Network Out of Network
Generic Rx $17.00
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx 50% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible

Other Plans

Other plans that are available in the state.

Plan Name
Humana Basic 6600/Atlanta HMOx
Humana Bronze 6300/Atlanta HMOx
Humana Bronze 4850/Atlanta HMOx
Humana Silver 4600/Atlanta HMOx
Humana Gold 2500/Atlanta HMOx
Humana Platinum 1000/Atlanta HMOx
Humana Basic 6600/Columbus GA HMOx
Humana Bronze 6300/Columbus GA HMOx
Humana Bronze 4850/Columbus GA HMOx
Humana Silver 4600/Columbus GA HMOx
Humana Gold 2500/Columbus GA HMOx
Humana Platinum 1000/Columbus GA HMOx
Humana Basic 6600/Macon HMOx
Humana Bronze 6300/Macon HMOx
Humana Silver 4600/Macon HMOx
Humana Gold 2500/Macon HMOx
Humana Platinum 1000/Macon HMOx
Humana Basic 6600/Savannah HMOx
Humana Bronze 6300/Savannah HMOx
Humana Silver 4600/Savannah HMOx
Humana Gold 2500/Savannah HMOx
Humana Platinum 1000/Savannah HMOx
Humana Basic 6600/National POS - OpenAccess
Humana Bronze 6300/National POS - OpenAccess
Humana Silver 4250/National POS - OpenAccess
Humana Gold 2500/National POS - OpenAccess
Humana Platinum 1000/National POS - OpenAccess
comments powered by Disqus