MedMutual Market Classic 2000 - Silver OH

Plan Information
Company MedMutual
State OH
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) $2,000 $6,000
Deductible (Family) $4,000 $12,000
Coinsurance 20% $0
Out of Pocket Maximum (Individual) $6,350 $0
Out of Pocket Maximum (Family) $12,700
Services In Network Out of Network
Primary Care Visit 20% Coinsurance after deductible $0
Specialist Visit 20% Coinsurance after deductible $0
In Patient Hospital Services 20% Coinsurance after deductible $0
Emergency Room Services 20% Coinsurance after deductible 20% coinsurance
Mental / Behavioral Health 20% coinsurance $0
Imaging (CT/PET Scans, MRIs) 20% coinsurance $0
Rehabilitative Speech Therapy 20% coinsurance $0
Rehabilitative Occupational & Physical Therapy 20% coinsurance $0
Preventative Care $0 $0
Laboratory Outpatient and Professional Services 20% coinsurance $0
X-ray and Diagnostic Imaging 20% coinsurance $0
Prescription Drugs In Network Out of Network
Generic Rx 20% Coinsurance after deductible
Preferred Brand Rx 20% Coinsurance after deductible
Non Preferred Brand Rx 20% Coinsurance after deductible
Specialty Drugs 20% 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.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $1,500.00
Deductible (Family) $3,000.00
Out of Pocket Maximum (Individual) $5,000.00
Out of Pocket Maximum (Family) $10,000.00
Services In Network Out of Network
Primary Care Physician 20% Coinsurance after deductible
Specialists 20% Coinsurance after deductible
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 20% Coinsurance after deductible
Preferred Brand Rx 20% Coinsurance after deductible
Non Preferred Brand Rx 20% Coinsurance after deductible
Specialty Drugs 20% 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) $500.00
Deductible (Family) $1,000.00
Out of Pocket Maximum (Individual) $2,100.00
Out of Pocket Maximum (Family) $4,200.00
Services In Network Out of Network
Primary Care Physician 10% Coinsurance after deductible
Specialists 10% Coinsurance after deductible
Emergency Room 10% Coinsurance after deductible
Inpatient Facility 10% Coinsurance after deductible
Inpatient Physician 10% Coinsurance after deductible
Prescription Drugs In Network Out of Network
Generic Rx 10% Coinsurance after deductible
Preferred Brand Rx 10% Coinsurance after deductible
Non Preferred Brand Rx 10% Coinsurance after deductible
Specialty Drugs 10% 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) $100.00
Deductible (Family) $200.00
Out of Pocket Maximum (Individual) $1,000.0
Out of Pocket Maximum (Family) $2,000.00
Services In Network Out of Network
Primary Care Physician 10% Coinsurance after deductible
Specialists 10% Coinsurance after deductible
Emergency Room 10% Coinsurance after deductible
Inpatient Facility 10% Coinsurance after deductible
Inpatient Physician 10% Coinsurance after deductible
Prescription Drugs In Network Out of Network
Generic Rx 10% Coinsurance after deductible
Preferred Brand Rx 10% Coinsurance after deductible
Non Preferred Brand Rx 10% Coinsurance after deductible
Specialty Drugs 10% Coinsurance after deductible

Other Plans

Other plans that are available in the state.

Plan Name
Market Classic 1000 - Gold
Market Classic 1000 Child Only - Gold
Market Classic 2000 - Silver
Market Classic 2000 Child Only - Silver
Market Classic 5000 - Bronze
Market Classic 5000 Child Only - Bronze
Market HSA 2000 - Gold
Market HSA 2000 Child Only - Gold
Market HSA 4000 - Bronze
Market HSA 4000 Child Only - Bronze
Market HSA 6000 - Bronze
Market HSA 6000 Child Only - Bronze
Market Young Adult Essentials
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