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Health - HMO 7150 Elite Catastrophic
Illinois, 2017
Plan Type
HMO
Metal Tier
Catastrophic
Out of Pocket Maximum
$7,150
Deductible
$7,150
Emergency Room Care: 0% Coinsurance after deductible
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) | $7,150 |
|---|---|
| Deductible (Family) | $14,300 |
| Coinsurance | Not applicable |
| Out of Pocket Maximum (Individual) | $7,150 |
| Out of Pocket Maximum (Family) | $14,300 |
Doctor Visits
| Primary Care Visit | 0% Coinsurance after deductible |
|---|---|
| Specialist Visit | 0% Coinsurance after deductible |
| Inpatient Facility | 0% Coinsurance after deductible |
| Inpatient Physician | 0% Coinsurance after deductible |
| Emergency Room Services | 0% Coinsurance after deductible |
Tests and Imaging
| Imaging (CT/PET Scans, MRIs) | 0% Coinsurance after deductible |
|---|---|
| Laboratory Outpatient and Professional Services | 0% Coinsurance after deductible |
| X-Ray and Diagnostic Imaging | 0% Coinsurance after deductible |
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 | 0% Coinsurance after deductible |
|---|---|
| Mental / Behavioral Health Outpatient | 0% Coinsurance after deductible |
| Rehabilitative Speech Therapy | 0% Coinsurance after deductible |
| Rehabilitative Occupational & Physical Therapy | 0% Coinsurance after deductible |
| Outpatient Facility | 0% Coinsurance after deductible |
| Outpatient Surgery | 0% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | 0% Coinsurance after deductible |
|---|---|
| Preferred Brand Rx | 0% Coinsurance after deductible |
| Non Preferred Brand Rx | 0% Coinsurance after deductible |
| Specialty Drugs | 0% Coinsurance after deductible |
Other Plans in Illinois
| Plan | Deductible | Coinsurance | Out of Pocket |
|---|---|---|---|
| Plan POS 6650 Elite Bronze | Deductible $6,650 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan HMO 6650 Elite Bronze | Deductible $6,650 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan HMO 4500 Elite Silver | Deductible $4,500 | Coinsurance Not applicable | Out of Pocket $6,500 |
| Plan HMO HSA 3250 Elite Silver | Deductible $3,250 | Coinsurance Not applicable | Out of Pocket $5,000 |
| Plan POS 6000b Methodist Silver | Deductible $6,000 | Coinsurance Not applicable | Out of Pocket $6,000 |
| Plan POS 3500 Elite Silver | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan HMO 1500a Elite Gold | Deductible $1,500 | Coinsurance Not applicable | Out of Pocket $5,500 |
| Plan HMO 3000b Elite Silver | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $6,850 |
| Plan HMO 3500 Elite Silver | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan HMO 5000c Elite Silver | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $6,250 |
| Plan HMO 4000d Elite Bronze | Deductible $4,000 | Coinsurance Not applicable | Out of Pocket $6,850 |
| Plan POS 5000a Elite Bronze | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan POS 6000b Elite Silver | Deductible $6,000 | Coinsurance Not applicable | Out of Pocket $6,000 |
| Plan POS 5000a Methodist Bronze | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan HMO 3800 Elite Bronze | Deductible $3,800 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan HMO 4000b Elite Silver | Deductible $4,000 | Coinsurance Not applicable | Out of Pocket $6,250 |