Health - HMO HSA 3250 Elite Silver

Illinois, 2017

  • Plan Type

    HMO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $5,000

  • Deductible

    $3,250

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

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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) $3,250
Deductible (Family) $6,500
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $5,000
Out of Pocket Maximum (Family) $10,000

Doctor Visits

Primary Care Visit 20% Coinsurance after deductible
Specialist Visit 20% Coinsurance after deductible
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible
Emergency Room Services 20% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 20% Coinsurance after deductible
Laboratory Outpatient and Professional Services 20% Coinsurance after deductible
X-Ray and Diagnostic Imaging 20% 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 20% Coinsurance after deductible
Mental / Behavioral Health Outpatient 20% Coinsurance after deductible
Rehabilitative Speech Therapy 20% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 20% Coinsurance after deductible
Outpatient Facility 20% Coinsurance after deductible
Outpatient Surgery 20% Coinsurance after deductible

Prescription Drugs

Generic Rx 20% Coinsurance after deductible
Preferred Brand Rx 20% Coinsurance after deductible
Non Preferred Brand Rx 20% 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

Deductible (Individual) $3,250
Deductible (Family) $6,500
Out of Pocket Maximum (Individual) $3,500
Out of Pocket Maximum (Family) $7,000

Doctor Visits

Primary Care Physician 20% Coinsurance after deductible
Specialists 20% Coinsurance after deductible
Emergency Room 20% Coinsurance after deductible
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible

Prescription Drugs

Generic Rx 20% Coinsurance after deductible
Preferred Brand Rx 20% Coinsurance after deductible
Non Preferred Brand Rx 20% 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

Deductible (Individual) $500
Deductible (Family) $1,000
Out of Pocket Maximum (Individual) $1,750
Out of Pocket Maximum (Family) $3,500

Doctor Visits

Primary Care Physician 20% Coinsurance after deductible
Specialists 20% Coinsurance after deductible
Emergency Room 20% Coinsurance after deductible
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible

Prescription Drugs

Generic Rx 20% Coinsurance after deductible
Preferred Brand Rx 20% Coinsurance after deductible
Non Preferred Brand Rx 20% 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

Deductible (Individual) $0
Deductible (Family) $0
Out of Pocket Maximum (Individual) $1,700
Out of Pocket Maximum (Family) $3,400

Doctor Visits

Primary Care Physician 10% Coinsurance after deductible
Specialists 10% Coinsurance after deductible
Emergency Room 10% Coinsurance after deductible
Inpatient Facility 10% Coinsurance after deductible
Inpatient Physician 10% Coinsurance after deductible

Prescription Drugs

Generic Rx 10% Coinsurance after deductible
Preferred Brand Rx 10% Coinsurance after deductible
Non Preferred Brand Rx 10% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible

Other Plans in Illinois

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 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
Plan HMO 7150 Elite Catastrophic Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
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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) $3,250
Deductible (Family) $6,500
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $5,000
Out of Pocket Maximum (Family) $10,000

Doctor Visits

Primary Care Visit 20% Coinsurance after deductible
Specialist Visit 20% Coinsurance after deductible
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible
Emergency Room Services 20% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 20% Coinsurance after deductible
Laboratory Outpatient and Professional Services 20% Coinsurance after deductible
X-Ray and Diagnostic Imaging 20% 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 20% Coinsurance after deductible
Mental / Behavioral Health Outpatient 20% Coinsurance after deductible
Rehabilitative Speech Therapy 20% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 20% Coinsurance after deductible
Outpatient Facility 20% Coinsurance after deductible
Outpatient Surgery 20% Coinsurance after deductible

Prescription Drugs

Generic Rx 20% Coinsurance after deductible
Preferred Brand Rx 20% Coinsurance after deductible
Non Preferred Brand Rx 20% 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

Deductible (Individual) $3,250
Deductible (Family) $6,500
Out of Pocket Maximum (Individual) $3,500
Out of Pocket Maximum (Family) $7,000

Doctor Visits

Primary Care Physician 20% Coinsurance after deductible
Specialists 20% Coinsurance after deductible
Emergency Room 20% Coinsurance after deductible
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible

Prescription Drugs

Generic Rx 20% Coinsurance after deductible
Preferred Brand Rx 20% Coinsurance after deductible
Non Preferred Brand Rx 20% 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

Deductible (Individual) $500
Deductible (Family) $1,000
Out of Pocket Maximum (Individual) $1,750
Out of Pocket Maximum (Family) $3,500

Doctor Visits

Primary Care Physician 20% Coinsurance after deductible
Specialists 20% Coinsurance after deductible
Emergency Room 20% Coinsurance after deductible
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible

Prescription Drugs

Generic Rx 20% Coinsurance after deductible
Preferred Brand Rx 20% Coinsurance after deductible
Non Preferred Brand Rx 20% 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

Deductible (Individual) $0
Deductible (Family) $0
Out of Pocket Maximum (Individual) $1,700
Out of Pocket Maximum (Family) $3,400

Doctor Visits

Primary Care Physician 10% Coinsurance after deductible
Specialists 10% Coinsurance after deductible
Emergency Room 10% Coinsurance after deductible
Inpatient Facility 10% Coinsurance after deductible
Inpatient Physician 10% Coinsurance after deductible

Prescription Drugs

Generic Rx 10% Coinsurance after deductible
Preferred Brand Rx 10% Coinsurance after deductible
Non Preferred Brand Rx 10% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible

Other Plans in Illinois

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 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
Plan HMO 7150 Elite Catastrophic Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150