Molina Molina Marketplace Silver Plan OH

Plan Information
Company Molina Marketplace
State OH
Metal Tier Silver
Plan Type HMO

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) $1,700 $0
Deductible (Family) $3,400 $0
Coinsurance Data Not Available $0
Out of Pocket Maximum (Individual) $6,350 $0
Out of Pocket Maximum (Family) $12,700 $0
Services In Network Out of Network
Primary Care Visit $40 $0
Specialist Visit $65 $0
In Patient Hospital Services 30% $0
Emergency Room Services $250 Data Not Available
Mental / Behavioral Health Data Not Available $0
Imaging (CT/PET Scans, MRIs) Data Not Available $0
Rehabilitative Speech Therapy Data Not Available $0
Rehabilitative Occupational & Physical Therapy Data Not Available $0
Preventative Care $0 $0
Laboratory Outpatient and Professional Services Data Not Available $0
X-ray and Diagnostic Imaging Data Not Available $0
Outpatient Facility Data Not Available $0
Outpatient Surgery Data Not Available $0
Prescription Drugs In Network Out of Network
Generic Rx $20
Preferred Brand Rx $55
Non Preferred Brand Rx 30%
Specialty Drugs 30%

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) $1,500.00
Deductible (Family) $3,000.00
Out of Pocket Maximum (Individual) $5,200.00
Out of Pocket Maximum (Family) $10,400.00
Services In Network Out of Network
Primary Care Physician $30
Specialists $60
Emergency Room $250
Inpatient Facility 30%
Inpatient Physician 30%
Prescription Drugs In Network Out of Network
Generic Rx $20.00
Preferred Brand Rx $40
Non Preferred Brand Rx 30%
Specialty Drugs 30%

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) $0.00
Deductible (Family) $0.00
Out of Pocket Maximum (Individual) $2,250.00
Out of Pocket Maximum (Family) $4,500.00
Services In Network Out of Network
Primary Care Physician $15
Specialists $40
Emergency Room $150
Inpatient Facility 25%
Inpatient Physician 25%
Prescription Drugs In Network Out of Network
Generic Rx $10.00
Preferred Brand Rx $20
Non Preferred Brand Rx 25%
Specialty Drugs 25%

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) $0.00
Deductible (Family) $0.00
Out of Pocket Maximum (Individual) $2,250.0
Out of Pocket Maximum (Family) $4,500.00
Services In Network Out of Network
Primary Care Physician No Charge
Specialists $10
Emergency Room $100
Inpatient Facility 10%
Inpatient Physician 10%
Prescription Drugs In Network Out of Network
Generic Rx $3.00
Preferred Brand Rx $8
Non Preferred Brand Rx 10%
Specialty Drugs 10%

Other Plans

Other plans that are available in the state.

Plan Name
Molina Marketplace Bronze Plan
Molina Marketplace Gold Plan
Molina Marketplace Silver Plan
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