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) |
$6,550 |
Deductible (Family) |
$13,100 |
Coinsurance |
Not applicable |
Out of Pocket Maximum (Individual) |
$6,550 |
Out of Pocket Maximum (Family) |
$13,100 |
Doctor Visits
Primary Care Visit |
No charge after deductible |
Specialist Visit |
No charge after deductible |
Inpatient Facility |
No charge after deductible |
Inpatient Physician |
No charge after deductible |
Emergency Room Services |
No charge after deductible |
Tests and Imaging
Imaging (CT/PET Scans, MRIs) |
No charge after deductible |
Laboratory Outpatient and Professional Services |
No charge after deductible |
X-Ray and Diagnostic Imaging |
No charge after deductible |
Health Management Programs
Asthma |
Not available |
Depression |
Not available |
Diabetes |
Available |
Heart Disease |
Available |
High Blood Pressure / High Cholesterol |
Not available |
Lower Back Pain |
Not available |
Pain Management |
Not available |
Pregnancy |
Available |
Weight Loss |
Not available |
Other
Mental / Behavioral Health Inpatient |
No charge after deductible |
Mental / Behavioral Health Outpatient |
No charge after deductible |
Rehabilitative Speech Therapy |
No charge after deductible |
Rehabilitative Occupational & Physical Therapy |
No charge after deductible |
Outpatient Facility |
No charge after deductible |
Outpatient Surgery |
No charge after deductible |
Prescription Drugs
Generic Rx |
No charge after deductible |
Preferred Brand Rx |
No charge after deductible |
Non Preferred Brand Rx |
No charge after deductible |
Specialty Drugs
| No charge after deductible |
Other Plans in Texas
Plan
Humana Bronze 6550/San Antonio HMOx
|
Deductible
$6,550 |
Coinsurance Not applicable |
Out of Pocket
$6,550 |
Plan
Humana Basic 7150/HMO Premier
|
Deductible
$7,150 |
Coinsurance Not applicable |
Out of Pocket
$7,150 |
Plan
Humana Bronze 6150/Waco HMOx
|
Deductible
$6,150 |
Coinsurance Not applicable |
Out of Pocket
$7,150 |
Plan
Humana Basic 7150/Corpus Christi HMOx
|
Deductible
$7,150 |
Coinsurance Not applicable |
Out of Pocket
$7,150 |
Plan
Humana Bronze 6150/San Antonio HMOx
|
Deductible
$6,150 |
Coinsurance Not applicable |
Out of Pocket
$7,150 |
Plan
Humana Silver 3550/HMO Premier
|
Deductible
$3,550 |
Coinsurance Not applicable |
Out of Pocket
$7,150 |
Plan
Humana Basic 7150/San Antonio HMOx
|
Deductible
$7,150 |
Coinsurance Not applicable |
Out of Pocket
$7,150 |
Plan
Humana Bronze 6150/Corpus Christi HMOx
|
Deductible
$6,150 |
Coinsurance Not applicable |
Out of Pocket
$7,150 |
Plan
Humana Bronze 6550/HMO Premier
|
Deductible
$6,550 |
Coinsurance Not applicable |
Out of Pocket
$6,550 |
Plan
Humana Silver 3550/Waco HMOx
|
Deductible
$3,550 |
Coinsurance Not applicable |
Out of Pocket
$7,150 |
Plan
Humana Basic 7150/Waco HMOx
|
Deductible
$7,150 |
Coinsurance Not applicable |
Out of Pocket
$7,150 |
Plan
Humana Gold 0/HMO Premier
|
Deductible
$0 |
Coinsurance Not applicable |
Out of Pocket
$5,000 |
Plan
Humana Silver 3550/San Antonio HMOx
|
Deductible
$3,550 |
Coinsurance Not applicable |
Out of Pocket
$7,150 |
Plan
Humana Bronze 6150/HMO Premier
|
Deductible
$6,150 |
Coinsurance Not applicable |
Out of Pocket
$7,150 |
Plan
Humana Bronze 6550/Corpus Christi HMOx
|
Deductible
$6,550 |
Coinsurance Not applicable |
Out of Pocket
$6,550 |
Plan
Humana Silver 3550/Corpus Christi HMOx
|
Deductible
$3,550 |
Coinsurance Not applicable |
Out of Pocket
$7,150 |