Hawaii - HMSA Silver HMO

Hawaii, 2017

  • Plan Type

    HMO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $7,150

  • Deductible

    $2,500

Enroll Now
{"state":{"code":"HI","name":"Hawaii","fips":15,"exchangeName":["Hawaii Health Connector"],"exchangeUrl":["http:\/\/www.hawaiihealthconnector.com\/"],"exchangeType":["State"]},"year":"2017","plan":{"name":"Hawaii - HMSA Silver HMO","planType":"HMO","tier":"Silver","oopm":"7150.00","deductible":"2500.00","redirectUrl":"https:\/\/www.healthcare.gov"},"phoneNum":"8558665590"}

Call (855) 866-5590 to speak with a licensed agent about a new health plan.

{"onCurrent":true}

Cost Sharing Benefits (In Network)

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) $2,500
Deductible (Family) $5,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,150
Out of Pocket Maximum (Family) $14,300

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility $300 Copay per day after deductible
Inpatient Physician 30% Coinsurance after deductible
Emergency Room Services $250 Copay after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) $300 Copay after deductible
Laboratory Outpatient and Professional Services Data Not Available
X-Ray and Diagnostic Imaging Data Not Available

Health Management Programs

Asthma Available
Depression Available
Diabetes Available
Heart Disease Available
High Blood Pressure / High Cholesterol Available
Lower Back Pain Not available
Pain Management Not available
Pregnancy Available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient No charge after deductible
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy $20 Copay after deductible
Rehabilitative Occupational & Physical Therapy $20 Copay after deductible
Outpatient Facility 30% Coinsurance after deductible
Outpatient Surgery 30% Coinsurance after deductible

Prescription Drugs

Generic Rx Data Not Available
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx $100 Copay 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. 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) $2,000
Deductible (Family) $4,000
Out of Pocket Maximum (Individual) $5,700
Out of Pocket Maximum (Family) $11,400

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $250 Copay after deductible
Inpatient Facility $300 Copay per day after deductible
Inpatient Physician 30% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx $100 Copay 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

Deductible (Individual) $500
Deductible (Family) $1,000
Out of Pocket Maximum (Individual) $2,350
Out of Pocket Maximum (Family) $4,700

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $250 Copay after deductible
Inpatient Facility $200 Copay per day after deductible
Inpatient Physician 10% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
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

Deductible (Individual) $0
Deductible (Family) $0
Out of Pocket Maximum (Individual) $1,300
Out of Pocket Maximum (Family) $2,600

Doctor Visits

Primary Care Physician
Specialists
Emergency Room
Inpatient Facility $100 Copay per day
Inpatient Physician

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

Other Plans in Hawaii

Plan HMSA Bronze PPO 7150 Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Gold PPO Deductible $0 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Bronze HMO Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Platinum PPO Deductible $0 Coinsurance Not applicable Out of Pocket $6,850
Plan HMSA Silver PPO 1500 Deductible $1,500 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Silver PPO 2500 Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Platinum HMO Deductible $0 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Silver PPO 3500 Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Gold PPO 1000 Deductible $1,000 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Catastrophic Plan Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Gold HMO Deductible $1,000 Coinsurance Not applicable Out of Pocket $7,150
{"onCurrent":true,"type":"tools"}

Cost Sharing Benefits (In Network)

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) $2,500
Deductible (Family) $5,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,150
Out of Pocket Maximum (Family) $14,300

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility $300 Copay per day after deductible
Inpatient Physician 30% Coinsurance after deductible
Emergency Room Services $250 Copay after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) $300 Copay after deductible
Laboratory Outpatient and Professional Services Data Not Available
X-Ray and Diagnostic Imaging Data Not Available

Health Management Programs

Asthma Available
Depression Available
Diabetes Available
Heart Disease Available
High Blood Pressure / High Cholesterol Available
Lower Back Pain Not available
Pain Management Not available
Pregnancy Available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient No charge after deductible
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy $20 Copay after deductible
Rehabilitative Occupational & Physical Therapy $20 Copay after deductible
Outpatient Facility 30% Coinsurance after deductible
Outpatient Surgery 30% Coinsurance after deductible

Prescription Drugs

Generic Rx Data Not Available
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx $100 Copay 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. 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) $2,000
Deductible (Family) $4,000
Out of Pocket Maximum (Individual) $5,700
Out of Pocket Maximum (Family) $11,400

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $250 Copay after deductible
Inpatient Facility $300 Copay per day after deductible
Inpatient Physician 30% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx $100 Copay 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

Deductible (Individual) $500
Deductible (Family) $1,000
Out of Pocket Maximum (Individual) $2,350
Out of Pocket Maximum (Family) $4,700

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $250 Copay after deductible
Inpatient Facility $200 Copay per day after deductible
Inpatient Physician 10% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
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

Deductible (Individual) $0
Deductible (Family) $0
Out of Pocket Maximum (Individual) $1,300
Out of Pocket Maximum (Family) $2,600

Doctor Visits

Primary Care Physician
Specialists
Emergency Room
Inpatient Facility $100 Copay per day
Inpatient Physician

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

Other Plans in Hawaii

Plan HMSA Bronze PPO 7150 Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Gold PPO Deductible $0 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Bronze HMO Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Platinum PPO Deductible $0 Coinsurance Not applicable Out of Pocket $6,850
Plan HMSA Silver PPO 1500 Deductible $1,500 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Silver PPO 2500 Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Platinum HMO Deductible $0 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Silver PPO 3500 Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Gold PPO 1000 Deductible $1,000 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Catastrophic Plan Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan HMSA Gold HMO Deductible $1,000 Coinsurance Not applicable Out of Pocket $7,150