New - CO-OPTIONS Connect Silver HMO, a Multi-State Plan

New Mexico, 2017

  • Plan Type

    HMO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $7,150

  • Deductible

    $3,500

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) $3,500
Deductible (Family) $7,000
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 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible
Emergency Room Services Data Not Available

Tests and Imaging

Imaging (CT/PET Scans, MRIs) Data Not Available
Laboratory Outpatient and Professional Services No charge
X-Ray and Diagnostic Imaging No charge

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 Not available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient 20% Coinsurance after deductible
Mental / Behavioral Health Outpatient No charge
Rehabilitative Speech Therapy Data Not Available
Rehabilitative Occupational & Physical Therapy Data Not Available
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) $3,000
Deductible (Family) $6,000
Out of Pocket Maximum (Individual) $5,700
Out of Pocket Maximum (Family) $11,400

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

Doctor Visits

Primary Care Physician
Specialists
Emergency Room
Inpatient Facility 10% Coinsurance after deductible
Inpatient Physician 10% 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) $0
Deductible (Family) $0
Out of Pocket Maximum (Individual) $2,000
Out of Pocket Maximum (Family) $4,000

Doctor Visits

Primary Care Physician
Specialists
Emergency Room
Inpatient Facility
Inpatient Physician

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

Other Plans in New Mexico

Plan Care Connect HDHP Bronze Deductible $6,550 Coinsurance Not applicable Out of Pocket $6,550
Plan Care Connect Bronze Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Healthy Connect Bronze Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Care Connect Catastrophic Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan CO-OPTIONS Connect Gold HMO, a Multi-State Plan Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,150
Plan Care Connect Silver Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Healthy Connect Gold Deductible $1,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Care Connect Silver Plus Deductible $3,000 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) $3,500
Deductible (Family) $7,000
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 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible
Emergency Room Services Data Not Available

Tests and Imaging

Imaging (CT/PET Scans, MRIs) Data Not Available
Laboratory Outpatient and Professional Services No charge
X-Ray and Diagnostic Imaging No charge

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 Not available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient 20% Coinsurance after deductible
Mental / Behavioral Health Outpatient No charge
Rehabilitative Speech Therapy Data Not Available
Rehabilitative Occupational & Physical Therapy Data Not Available
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) $3,000
Deductible (Family) $6,000
Out of Pocket Maximum (Individual) $5,700
Out of Pocket Maximum (Family) $11,400

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

Doctor Visits

Primary Care Physician
Specialists
Emergency Room
Inpatient Facility 10% Coinsurance after deductible
Inpatient Physician 10% 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) $0
Deductible (Family) $0
Out of Pocket Maximum (Individual) $2,000
Out of Pocket Maximum (Family) $4,000

Doctor Visits

Primary Care Physician
Specialists
Emergency Room
Inpatient Facility
Inpatient Physician

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

Other Plans in New Mexico

Plan Care Connect HDHP Bronze Deductible $6,550 Coinsurance Not applicable Out of Pocket $6,550
Plan Care Connect Bronze Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Healthy Connect Bronze Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Care Connect Catastrophic Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan CO-OPTIONS Connect Gold HMO, a Multi-State Plan Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,150
Plan Care Connect Silver Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Healthy Connect Gold Deductible $1,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Care Connect Silver Plus Deductible $3,000 Coinsurance Not applicable Out of Pocket $7,150