Blue - Saver PCB Silver

Kansas, 2017

  • Plan Type

    PPO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $5,000

  • Deductible

    $3,000

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

Doctor Visits

Primary Care Visit 10% Coinsurance after deductible
Specialist Visit 10% Coinsurance after deductible
Inpatient Facility 10% Coinsurance after deductible
Inpatient Physician 10% Coinsurance after deductible
Emergency Room Services 10% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 10% Coinsurance after deductible
Laboratory Outpatient and Professional Services 10% Coinsurance after deductible
X-Ray and Diagnostic Imaging 10% 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 10% Coinsurance after deductible
Mental / Behavioral Health Outpatient 10% Coinsurance after deductible
Rehabilitative Speech Therapy 10% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 10% Coinsurance after deductible
Outpatient Facility 10% Coinsurance after deductible
Outpatient Surgery 10% Coinsurance after deductible

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $55 Copay after deductible
Non Preferred Brand Rx 20% Coinsurance after deductible
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) $2,500
Deductible (Family) $5,000
Out of Pocket Maximum (Individual) $4,500
Out of Pocket Maximum (Family) $9,000

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 $5 Copay after deductible
Preferred Brand Rx $15 Copay after deductible
Non Preferred Brand Rx 20% Coinsurance after deductible
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

Deductible (Individual) $950
Deductible (Family) $1,900
Out of Pocket Maximum (Individual) $1,450
Out of Pocket Maximum (Family) $2,900

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 $5 Copay after deductible
Preferred Brand Rx $15 Copay after deductible
Non Preferred Brand Rx 20% Coinsurance after deductible
Specialty Drugs 30% 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) $350
Deductible (Family) $700
Out of Pocket Maximum (Individual) $725
Out of Pocket Maximum (Family) $1,450

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 $5 Copay after deductible
Preferred Brand Rx $15 Copay after deductible
Non Preferred Brand Rx 20% Coinsurance after deductible
Specialty Drugs 30% Coinsurance after deductible

Other Plans in Kansas

Plan First PCB Bronze Deductible $6,900 Coinsurance Not applicable Out of Pocket $7,150
Plan First Select Bronze Deductible $6,900 Coinsurance Not applicable Out of Pocket $7,150
Plan Basic Select Silver Deductible $3,500 Coinsurance Not applicable Out of Pocket $5,000
Plan Saver PCB Bronze Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,550
Plan Standard PCB Silver Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Standard PCB Bronze Deductible $6,650 Coinsurance Not applicable Out of Pocket $7,150
Plan Saver PCB Gold Deductible $1,500 Coinsurance Not applicable Out of Pocket $3,000
Plan First Select Silver Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,000
Plan Basic Select Bronze Deductible $6,350 Coinsurance Not applicable Out of Pocket $7,150
Plan Saver Select Gold Deductible $1,500 Coinsurance Not applicable Out of Pocket $3,000
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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) $3,000
Deductible (Family) $6,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $5,000
Out of Pocket Maximum (Family) $10,000

Doctor Visits

Primary Care Visit 10% Coinsurance after deductible
Specialist Visit 10% Coinsurance after deductible
Inpatient Facility 10% Coinsurance after deductible
Inpatient Physician 10% Coinsurance after deductible
Emergency Room Services 10% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 10% Coinsurance after deductible
Laboratory Outpatient and Professional Services 10% Coinsurance after deductible
X-Ray and Diagnostic Imaging 10% 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 10% Coinsurance after deductible
Mental / Behavioral Health Outpatient 10% Coinsurance after deductible
Rehabilitative Speech Therapy 10% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 10% Coinsurance after deductible
Outpatient Facility 10% Coinsurance after deductible
Outpatient Surgery 10% Coinsurance after deductible

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $55 Copay after deductible
Non Preferred Brand Rx 20% Coinsurance after deductible
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) $2,500
Deductible (Family) $5,000
Out of Pocket Maximum (Individual) $4,500
Out of Pocket Maximum (Family) $9,000

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 $5 Copay after deductible
Preferred Brand Rx $15 Copay after deductible
Non Preferred Brand Rx 20% Coinsurance after deductible
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

Deductible (Individual) $950
Deductible (Family) $1,900
Out of Pocket Maximum (Individual) $1,450
Out of Pocket Maximum (Family) $2,900

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 $5 Copay after deductible
Preferred Brand Rx $15 Copay after deductible
Non Preferred Brand Rx 20% Coinsurance after deductible
Specialty Drugs 30% 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) $350
Deductible (Family) $700
Out of Pocket Maximum (Individual) $725
Out of Pocket Maximum (Family) $1,450

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 $5 Copay after deductible
Preferred Brand Rx $15 Copay after deductible
Non Preferred Brand Rx 20% Coinsurance after deductible
Specialty Drugs 30% Coinsurance after deductible

Other Plans in Kansas

Plan First PCB Bronze Deductible $6,900 Coinsurance Not applicable Out of Pocket $7,150
Plan First Select Bronze Deductible $6,900 Coinsurance Not applicable Out of Pocket $7,150
Plan Basic Select Silver Deductible $3,500 Coinsurance Not applicable Out of Pocket $5,000
Plan Saver PCB Bronze Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,550
Plan Standard PCB Silver Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Standard PCB Bronze Deductible $6,650 Coinsurance Not applicable Out of Pocket $7,150
Plan Saver PCB Gold Deductible $1,500 Coinsurance Not applicable Out of Pocket $3,000
Plan First Select Silver Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,000
Plan Basic Select Bronze Deductible $6,350 Coinsurance Not applicable Out of Pocket $7,150
Plan Saver Select Gold Deductible $1,500 Coinsurance Not applicable Out of Pocket $3,000