Sendero - Sendero Health Plans IdealCare Essential

Texas, 2017

  • Plan Type

    HMO

  • Metal Tier

    Bronze

  • Out of Pocket Maximum

    $6,500

  • Deductible

    $6,150

Enroll Now
{"state":{"code":"TX","name":"Texas","fips":48,"exchangeName":["Healthcare.gov"],"exchangeUrl":["http:\/\/www.healthcare.gov"],"exchangeType":["Federal"]},"year":"2017","plan":{"name":"Sendero - Sendero Health Plans IdealCare Essential","planType":"HMO","tier":"Bronze","oopm":"6500.00","deductible":"6150.00","redirectUrl":"https:\/\/www.healthcare.gov"},"phoneNum":"8558665590"}

Call (855) 866-5590 to speak with a licensed agent about a new health plan.

{"onCurrent":true}

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) $6,150
Deductible (Family) $12,300
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 $50 Copay after deductible
Inpatient Facility $750 Copay per stay
Inpatient Physician No charge
Emergency Room Services $350 Copay after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 75% Coinsurance after deductible
Laboratory Outpatient and Professional Services 100% Coinsurance after deductible
X-Ray and Diagnostic Imaging 100% Coinsurance after deductible

Health Management Programs

Asthma Available
Depression 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 $750 Copay per stay
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy $50 Copay after deductible
Rehabilitative Occupational & Physical Therapy $50 Copay after deductible
Outpatient Facility 50% Coinsurance after deductible
Outpatient Surgery 50% Coinsurance after deductible

Prescription Drugs

Generic Rx Data Not Available
Preferred Brand Rx Data Not Available
Non Preferred Brand Rx $60 Copay after deductible
Specialty Drugs 30% Coinsurance after deductible

Other Plans in Texas

Plan Sendero Health Plans IdealCare Complete Deductible $6,100 Coinsurance Not applicable Out of Pocket $6,500
Plan Sendero Health Plans IdealCare Total Deductible $0 Coinsurance Not applicable Out of Pocket $6,600
{"onCurrent":true,"type":"tools"}

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) $6,150
Deductible (Family) $12,300
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 $50 Copay after deductible
Inpatient Facility $750 Copay per stay
Inpatient Physician No charge
Emergency Room Services $350 Copay after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 75% Coinsurance after deductible
Laboratory Outpatient and Professional Services 100% Coinsurance after deductible
X-Ray and Diagnostic Imaging 100% Coinsurance after deductible

Health Management Programs

Asthma Available
Depression 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 $750 Copay per stay
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy $50 Copay after deductible
Rehabilitative Occupational & Physical Therapy $50 Copay after deductible
Outpatient Facility 50% Coinsurance after deductible
Outpatient Surgery 50% Coinsurance after deductible

Prescription Drugs

Generic Rx Data Not Available
Preferred Brand Rx Data Not Available
Non Preferred Brand Rx $60 Copay after deductible
Specialty Drugs 30% Coinsurance after deductible

Other Plans in Texas

Plan Sendero Health Plans IdealCare Complete Deductible $6,100 Coinsurance Not applicable Out of Pocket $6,500
Plan Sendero Health Plans IdealCare Total Deductible $0 Coinsurance Not applicable Out of Pocket $6,600