Humana - Humana Silver 3550/San Antonio HMOx

Texas, 2017

  • Plan Type

    HMO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $7,150

  • Deductible

    $3,550

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) $3,550
Deductible (Family) $7,100
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 $600 Copay before 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 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 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 Data Not Available
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx 50% 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) $3,000
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 $450 Copay before deductible
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx $45 Copay after deductible
Non Preferred Brand Rx 50% 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) $900
Deductible (Family) $1,800
Out of Pocket Maximum (Individual) $2,050
Out of Pocket Maximum (Family) $4,100

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $450 Copay before deductible
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) $850
Out of Pocket Maximum (Family) $1,700

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $350 Copay before deductible
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

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 Bronze 6550/Waco HMOx Deductible $6,550 Coinsurance Not applicable Out of Pocket $6,550
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 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
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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) $3,550
Deductible (Family) $7,100
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 $600 Copay before 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 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 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 Data Not Available
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx 50% 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) $3,000
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 $450 Copay before deductible
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx $45 Copay after deductible
Non Preferred Brand Rx 50% 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) $900
Deductible (Family) $1,800
Out of Pocket Maximum (Individual) $2,050
Out of Pocket Maximum (Family) $4,100

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $450 Copay before deductible
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) $850
Out of Pocket Maximum (Family) $1,700

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $350 Copay before deductible
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

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 Bronze 6550/Waco HMOx Deductible $6,550 Coinsurance Not applicable Out of Pocket $6,550
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 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