Humana Humana National Preferred Silver 4250/6250 Plan IL

Plan Information
Company Humana Insurance Company
State IL
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) $4,250 $8,500
Deductible (Family) $8,500 $17,000
Coinsurance 20% 40%
Out of Pocket Maximum (Individual) $6,250 $25,000
Out of Pocket Maximum (Family) $12,500 $50,000
Services In Network Out of Network
Primary Care Visit $35 40% coinsurance
Specialist Visit $60 40% coinsurance
In Patient Hospital Services 20% Coinsurance after deductible 40% coinsurance
Emergency Room Services 20% Coinsurance after deductible 20% coinsurance
Mental / Behavioral Health 20% coinsurance 40% coinsurance
Imaging (CT/PET Scans, MRIs) 20% coinsurance 40% coinsurance
Rehabilitative Speech Therapy 20% coinsurance 40% coinsurance
Rehabilitative Occupational & Physical Therapy 20% coinsurance 40% coinsurance
Preventative Care $0 40% coinsurance
Laboratory Outpatient and Professional Services 20% coinsurance 40% coinsurance
X-ray and Diagnostic Imaging 20% coinsurance 40% coinsurance
Outpatient Facility 20% coinsurance 40% coinsurance
Outpatient Surgery 20% coinsurance 40% coinsurance
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/Chicago HMOx
Humana Bronze 6300/Chicago HMOx
Humana Bronze 4850/Chicago HMOx
Humana Silver 4600/Chicago HMOx
Humana Gold 2500/Chicago HMOx
Humana Platinum 1000/Chicago HMOx
Humana Basic 6600/Rockford-Peoria HMOx
Humana Bronze 6300/Rockford-Peoria HMOx
Humana Bronze 4850/Rockford-Peoria HMOx
Humana Silver 4600/Rockford-Peoria HMOx
Humana Gold 2500/Rockford-Peoria HMOx
Humana Platinum 1000/Rockford-Peoria HMOx
Humana Basic 6600/Springfield HMOx
Humana Bronze 6300/Springfield HMOx
Humana Bronze 4850/Springfield IL HMOx
Humana Silver 4600/Springfield IL HMOx
Humana Gold 2500/Springfield IL HMOx
Humana Platinum 1000/Springfield IL HMOx
Humana Basic 6600/Choice POS
Humana Bronze 6300/Choice POS
Humana Bronze 4850/Choice POS
Humana Silver 4250/Choice POS
Humana Silver 3650/Choice POS
Humana Gold 2500/Choice POS
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