Physicians - Sparrow PHP Silver 2500 HMO

Michigan, 2017

  • Plan Type

    HMO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $6,500

  • Deductible

    $2,500

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) $2,500
Deductible (Family) $5,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,500
Out of Pocket Maximum (Family) $13,000

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible
Emergency Room Services Data Not Available

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

Other

Mental / Behavioral Health Inpatient 20% Coinsurance after deductible
Mental / Behavioral Health Outpatient Data Not Available
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 Data Not Available
Preferred Brand Rx Data Not Available
Non Preferred Brand Rx Data Not Available
Specialty Drugs

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) $5,000
Out of Pocket Maximum (Family) $10,000

Doctor Visits

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

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

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) $2,000
Out of Pocket Maximum (Family) $4,000

Doctor Visits

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

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

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) $250
Deductible (Family) $500
Out of Pocket Maximum (Individual) $1,500
Out of Pocket Maximum (Family) $3,000

Doctor Visits

Primary Care Physician
Specialists
Emergency Room
Inpatient Facility 0% Coinsurance after deductible
Inpatient Physician 0% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

Other Plans in Michigan

Plan Sparrow PHP Silver 3500 HMO Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Gold 1250 HMO Deductible $1,250 Coinsurance Not applicable Out of Pocket $4,750
Plan Sparrow PHP Bronze 6650 HMO Deductible $6,650 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Silver 4000 Exclusive Deductible $4,000 Coinsurance Not applicable Out of Pocket $6,600
Plan Sparrow PHP Silver 3000 Exclusive Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,600
Plan Sparrow PHP Gold 500 Basic Exclusive Deductible $500 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Silver HDHP Exclusive Deductible $2,700 Coinsurance Not applicable Out of Pocket $4,000
Plan Sparrow PHP Healthy HMO Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Silver 5000 Exclusive Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Silver 3000 HMO Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,600
Plan Sparrow PHP Bronze 6650 Exclusive Deductible $6,650 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Silver HDHP HMO Deductible $2,700 Coinsurance Not applicable Out of Pocket $4,000
Plan Sparrow PHP Bronze 5500 H.S.A. HMO Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Sparrow PHP Gold 500 Exclusive Deductible $500 Coinsurance Not applicable Out of Pocket $4,200
Plan Sparrow PHP Gold 500 HMO Deductible $500 Coinsurance Not applicable Out of Pocket $4,200
Plan Sparrow PHP Silver 3500 Exclusive Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Gold 1000 HMO Deductible $1,000 Coinsurance Not applicable Out of Pocket $5,000
Plan Sparrow PHP Silver 5000 HMO Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Silver 2000 Exclusive Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,800
Plan Sparrow PHP Silver 4000 HMO Deductible $4,000 Coinsurance Not applicable Out of Pocket $6,600
Plan Sparrow PHP Platinum 250 Exclusive Deductible $250 Coinsurance Not applicable Out of Pocket $1,250
Plan Sparrow PHP Bronze 5500 H.S.A. Exclusive Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Sparrow PHP Silver 2500 Exclusive Deductible $2,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Sparrow PHP Platinum 500-100Percent HMO Deductible $500 Coinsurance Not applicable Out of Pocket $1,800
Plan Sparrow PHP Gold 1400 H.S.A. HMO Deductible $1,400 Coinsurance Not applicable Out of Pocket $3,000
Plan Sparrow PHP Bronze 6550 H.S.A. Exclusive Deductible $6,550 Coinsurance Not applicable Out of Pocket $6,550
Plan Sparrow PHP Gold 1400 H.S.A. Exclusive Deductible $1,400 Coinsurance Not applicable Out of Pocket $3,000
Plan Sparrow PHP Bronze 6550 H.S.A. HMO Deductible $6,550 Coinsurance Not applicable Out of Pocket $6,550
Plan Sparrow PHP Gold 500 Basic HMO Deductible $500 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Platinum 250 HMO Deductible $250 Coinsurance Not applicable Out of Pocket $1,250
Plan Sparrow PHP Gold 1250 Exclusive Deductible $1,250 Coinsurance Not applicable Out of Pocket $4,750
Plan Sparrow PHP Platinum 500-100Percent Exclusive Deductible $500 Coinsurance Not applicable Out of Pocket $1,800
Plan Sparrow PHP Silver 2000 HMO Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,800
Plan Sparrow PHP Gold 1000 Exclusive Deductible $1,000 Coinsurance Not applicable Out of Pocket $5,000
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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) $2,500
Deductible (Family) $5,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,500
Out of Pocket Maximum (Family) $13,000

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible
Emergency Room Services Data Not Available

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

Other

Mental / Behavioral Health Inpatient 20% Coinsurance after deductible
Mental / Behavioral Health Outpatient Data Not Available
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 Data Not Available
Preferred Brand Rx Data Not Available
Non Preferred Brand Rx Data Not Available
Specialty Drugs

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) $5,000
Out of Pocket Maximum (Family) $10,000

Doctor Visits

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

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

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) $2,000
Out of Pocket Maximum (Family) $4,000

Doctor Visits

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

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

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) $250
Deductible (Family) $500
Out of Pocket Maximum (Individual) $1,500
Out of Pocket Maximum (Family) $3,000

Doctor Visits

Primary Care Physician
Specialists
Emergency Room
Inpatient Facility 0% Coinsurance after deductible
Inpatient Physician 0% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

Other Plans in Michigan

Plan Sparrow PHP Silver 3500 HMO Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Gold 1250 HMO Deductible $1,250 Coinsurance Not applicable Out of Pocket $4,750
Plan Sparrow PHP Bronze 6650 HMO Deductible $6,650 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Silver 4000 Exclusive Deductible $4,000 Coinsurance Not applicable Out of Pocket $6,600
Plan Sparrow PHP Silver 3000 Exclusive Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,600
Plan Sparrow PHP Gold 500 Basic Exclusive Deductible $500 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Silver HDHP Exclusive Deductible $2,700 Coinsurance Not applicable Out of Pocket $4,000
Plan Sparrow PHP Healthy HMO Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Silver 5000 Exclusive Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Silver 3000 HMO Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,600
Plan Sparrow PHP Bronze 6650 Exclusive Deductible $6,650 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Silver HDHP HMO Deductible $2,700 Coinsurance Not applicable Out of Pocket $4,000
Plan Sparrow PHP Bronze 5500 H.S.A. HMO Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Sparrow PHP Gold 500 Exclusive Deductible $500 Coinsurance Not applicable Out of Pocket $4,200
Plan Sparrow PHP Gold 500 HMO Deductible $500 Coinsurance Not applicable Out of Pocket $4,200
Plan Sparrow PHP Silver 3500 Exclusive Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Gold 1000 HMO Deductible $1,000 Coinsurance Not applicable Out of Pocket $5,000
Plan Sparrow PHP Silver 5000 HMO Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Silver 2000 Exclusive Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,800
Plan Sparrow PHP Silver 4000 HMO Deductible $4,000 Coinsurance Not applicable Out of Pocket $6,600
Plan Sparrow PHP Platinum 250 Exclusive Deductible $250 Coinsurance Not applicable Out of Pocket $1,250
Plan Sparrow PHP Bronze 5500 H.S.A. Exclusive Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Sparrow PHP Silver 2500 Exclusive Deductible $2,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Sparrow PHP Platinum 500-100Percent HMO Deductible $500 Coinsurance Not applicable Out of Pocket $1,800
Plan Sparrow PHP Gold 1400 H.S.A. HMO Deductible $1,400 Coinsurance Not applicable Out of Pocket $3,000
Plan Sparrow PHP Bronze 6550 H.S.A. Exclusive Deductible $6,550 Coinsurance Not applicable Out of Pocket $6,550
Plan Sparrow PHP Gold 1400 H.S.A. Exclusive Deductible $1,400 Coinsurance Not applicable Out of Pocket $3,000
Plan Sparrow PHP Bronze 6550 H.S.A. HMO Deductible $6,550 Coinsurance Not applicable Out of Pocket $6,550
Plan Sparrow PHP Gold 500 Basic HMO Deductible $500 Coinsurance Not applicable Out of Pocket $7,150
Plan Sparrow PHP Platinum 250 HMO Deductible $250 Coinsurance Not applicable Out of Pocket $1,250
Plan Sparrow PHP Gold 1250 Exclusive Deductible $1,250 Coinsurance Not applicable Out of Pocket $4,750
Plan Sparrow PHP Platinum 500-100Percent Exclusive Deductible $500 Coinsurance Not applicable Out of Pocket $1,800
Plan Sparrow PHP Silver 2000 HMO Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,800
Plan Sparrow PHP Gold 1000 Exclusive Deductible $1,000 Coinsurance Not applicable Out of Pocket $5,000