Humana Humana Connect National Preferred Silver 4600/6300 Plan TX

Plan Information
Company Humana Health Plan of Texas, Inc.
State TX
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) $4,600 Data Not Available
Deductible (Family) $9,200 Data Not Available
Coinsurance Data Not Available Data Not Available
Out of Pocket Maximum (Individual) $6,300 Data Not Available
Out of Pocket Maximum (Family) $12,600 Data Not Available
Services In Network Out of Network
Primary Care Visit $25 Data Not Available
Specialist Visit $35 Data Not Available
In Patient Hospital Services 20% Coinsurance after deductible Data Not Available
Emergency Room Services 20% Coinsurance after deductible Data Not Available
Mental / Behavioral Health Data Not Available Data Not Available
Imaging (CT/PET Scans, MRIs) Data Not Available Data Not Available
Rehabilitative Speech Therapy Data Not Available Data Not Available
Rehabilitative Occupational & Physical Therapy Data Not Available Data Not Available
Preventative Care $0 Data Not Available
Laboratory Outpatient and Professional Services Data Not Available Data Not Available
X-ray and Diagnostic Imaging Data Not Available Data Not Available
Outpatient Facility Data Not Available Data Not Available
Outpatient Surgery Data Not Available Data Not Available
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) $4,750.00
Out of Pocket Maximum (Family) $9,500.00
Services In Network Out of Network
Primary Care Physician $25
Specialists $35
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) $900.00
Deductible (Family) $1,800.00
Out of Pocket Maximum (Individual) $1,450.00
Out of Pocket Maximum (Family) $2,900.00
Services In Network Out of Network
Primary Care Physician $25
Specialists $35
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 $25
Specialists $35
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
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