Consumers Choice Consumers' Choice Silver 2 (South Carolina)

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Company Consumers' Choice Health Plan
Plan Year 2014
State South Carolina
Metal Tier Silver
Plan Type EPO
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Cost Sharing Benefits (In Network)

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.

Deductible (Individual) $3,500
Deductible (Family) $7,000
Coinsurance 30%
Out of Pocket Maximum (Individual) $6,350
Out of Pocket Maximum (Family) $12,700

Doctors Visits

Primary Care Visit $25
Specialist Visit $50
In Patient Hospital Services 30% Coinsurance after deductible
Emergency Room Services 30% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 30% coinsurance
Laboratory Outpatient and Professional Services 30% coinsurance
X-ray and Diagnostic Imaging 30% coinsurance

Other

Mental / Behavioral Health 30% coinsurance
Rehabilitative Speech Therapy 30% coinsurance
Rehabilitative Occupational & Physical Therapy 30% coinsurance
Outpatient Facility 30% coinsurance
Outpatient Surgery 30% coinsurance

Prescription Drugs

Generic Rx $10
Preferred Brand Rx $40
Non Preferred Brand Rx $75
Specialty Drugs 30% 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

Deductible (Individual) $2,750.00
Deductible (Family) $5,500.00
Out of Pocket Maximum (Individual) $5,200.00
Out of Pocket Maximum (Family) $10,400.00
Primary Care Physician $20
Specialists $50
Emergency Room 30% Coinsurance after deductible
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible
Prescription Drugs In Network Out of Network
Generic Rx $10.00
Preferred Brand Rx $35
Non Preferred Brand Rx $60
Specialty Drugs 30% 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) $450.00
Deductible (Family) $900.00
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 $10
Specialists $30
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 $10.00
Preferred Brand Rx $25
Non Preferred Brand Rx $50
Specialty Drugs 20% 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) $150.00
Deductible (Family) $300.00
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 $5
Specialists $15
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 $4.00
Preferred Brand Rx $15
Non Preferred Brand Rx $35
Specialty Drugs 10% Coinsurance after deductible

Other Plans

Other plans that are available in the state.

Plan Name
Consumers' Choice Gold 1
Consumers' Choice Gold 2
Consumers' Choice Silver 1
Consumers' Choice Silver 2
Consumers' Choice Silver HDP 1
Consumers' Choice Bronze 1
Consumers' Choice Bronze HDP 1
Consumers' Choice Value Plan
Consumers' Choice Silver 10
Consumers' Choice Silver 11
Consumers' Choice Bronze 10
CO-OPtions Consumers' Choice Silver 12, A Multistate Plan
CO-OPtions Consumers Choice' Gold 4, A Multistate Plan

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