Physicians - Sparrow PHP Gold 1400 Exclusive

Michigan, 2018

  • Plan Type

    HMO

  • Metal Tier

    Gold

  • Out of Pocket Maximum

    $5,000

  • Deductible

    $1,400

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) $1,400
Deductible (Family) $2,800
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $5,000
Out of Pocket Maximum (Family) $10,000

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 20% Coinsurance after 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 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 30% Coinsurance after deductible

Other Plans in Michigan

Plan Sparrow PHP Silver 2000 Exclusive Deductible $2,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Silver 3500 Exclusive Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Gold 500 Exclusive Deductible $500 Coinsurance Not applicable Out of Pocket $5,200
Plan Sparrow PHP Gold 1400 H.S.A. Exclusive Deductible $1,400 Coinsurance Not applicable Out of Pocket $4,000
Plan Sparrow PHP Silver 3000 HMO Deductible $3,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Bronze 6650 Exclusive Deductible $6,650 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Healthy HMO Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Silver 5000 Exclusive Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Silver HDHP Exclusive Deductible $2,700 Coinsurance Not applicable Out of Pocket $4,000
Plan Sparrow PHP Gold 500 Basic Exclusive Deductible $500 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Silver 3000 Exclusive Deductible $3,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Silver 4000 Exclusive Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Gold 1000 Exclusive Deductible $1,000 Coinsurance Not applicable Out of Pocket $5,000
Plan Sparrow PHP Platinum 500-100Percent Exclusive Deductible $500 Coinsurance Not applicable Out of Pocket $2,200
Plan Sparrow PHP Bronze 6000 H.S.A. Exclusive Deductible $6,000 Coinsurance Not applicable Out of Pocket $6,000
Plan Sparrow PHP Platinum 250 HMO Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
Plan Sparrow PHP Gold 500 Basic HMO Deductible $500 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Gold 2000 Exclusive Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,800
Plan Sparrow PHP Bronze 6550 H.S.A. HMO Deductible $6,550 Coinsurance Not applicable Out of Pocket $6,550
Plan Sparrow PHP Bronze 6550 H.S.A. Exclusive Deductible $6,550 Coinsurance Not applicable Out of Pocket $6,550
Plan Sparrow PHP Silver 7000 Exclusive Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Silver 2500 Exclusive Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Bronze 5500 H.S.A. Exclusive Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Sparrow PHP Platinum 250 Exclusive Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
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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) $1,400
Deductible (Family) $2,800
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $5,000
Out of Pocket Maximum (Family) $10,000

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 20% Coinsurance after 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 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 30% Coinsurance after deductible

Other Plans in Michigan

Plan Sparrow PHP Silver 2000 Exclusive Deductible $2,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Silver 3500 Exclusive Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Gold 500 Exclusive Deductible $500 Coinsurance Not applicable Out of Pocket $5,200
Plan Sparrow PHP Gold 1400 H.S.A. Exclusive Deductible $1,400 Coinsurance Not applicable Out of Pocket $4,000
Plan Sparrow PHP Silver 3000 HMO Deductible $3,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Bronze 6650 Exclusive Deductible $6,650 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Healthy HMO Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Silver 5000 Exclusive Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Silver HDHP Exclusive Deductible $2,700 Coinsurance Not applicable Out of Pocket $4,000
Plan Sparrow PHP Gold 500 Basic Exclusive Deductible $500 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Silver 3000 Exclusive Deductible $3,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Silver 4000 Exclusive Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Gold 1000 Exclusive Deductible $1,000 Coinsurance Not applicable Out of Pocket $5,000
Plan Sparrow PHP Platinum 500-100Percent Exclusive Deductible $500 Coinsurance Not applicable Out of Pocket $2,200
Plan Sparrow PHP Bronze 6000 H.S.A. Exclusive Deductible $6,000 Coinsurance Not applicable Out of Pocket $6,000
Plan Sparrow PHP Platinum 250 HMO Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
Plan Sparrow PHP Gold 500 Basic HMO Deductible $500 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Gold 2000 Exclusive Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,800
Plan Sparrow PHP Bronze 6550 H.S.A. HMO Deductible $6,550 Coinsurance Not applicable Out of Pocket $6,550
Plan Sparrow PHP Bronze 6550 H.S.A. Exclusive Deductible $6,550 Coinsurance Not applicable Out of Pocket $6,550
Plan Sparrow PHP Silver 7000 Exclusive Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Silver 2500 Exclusive Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Bronze 5500 H.S.A. Exclusive Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Sparrow PHP Platinum 250 Exclusive Deductible $250 Coinsurance Not applicable Out of Pocket $1,500