Nevada Health Coop Southern Star Silver NV

Plan Information
Company Nevada Health Co-Op
State NV
Metal Tier Silver
Plan Type

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 $6,350
Deductible (Family) $8,500 $12,700
Coinsurance 30% 50%
Out of Pocket Maximum (Individual) $6,350 $20,000
Out of Pocket Maximum (Family) $12,700 $40,000
Services In Network Out of Network
Primary Care Visit $15 copay 50% coinsurance
Specialist Visit $50 copay 50% coinsurance
In Patient Hospital Services 30% coinsurance 50% coinsurance
Emergency Room Services 100 for first visit, 600 for subsequent visits 100 for first visit, 600 for subsequent visits
Mental / Behavioral Health 30% coinsurance 50% coinsurance
Imaging (CT/PET Scans, MRIs) $40 copay 50% coinsurance
Rehabilitative Speech Therapy $15 copay 50% coinsurance
Rehabilitative Occupational & Physical Therapy $15 copay 50% coinsurance
Preventative Care Data Not Available 50% coinsurance
Laboratory Outpatient and Professional Services $40 copay 50% coinsurance
X-ray and Diagnostic Imaging $40 copay 50% coinsurance
Outpatient Facility 30% coinsurance 50% coinsurance
Outpatient Surgery 30% coinsurance 50% coinsurance
Prescription Drugs In Network Out of Network
Generic Rx $10 copay
Preferred Brand Rx $35 copay
Non Preferred Brand Rx $50 copay
Specialty Drugs 0.3

Other Plans

Other plans that are available in the state.

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