Total - Total HMO Standard

Michigan, 2018

  • Plan Type

    HMO

  • Metal Tier

    Gold

  • Out of Pocket Maximum

    $5,000

  • Deductible

    $1,000

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) $1,000
Deductible (Family) $2,000
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 No charge after deductible
Inpatient Physician No charge 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 after deductible
X-Ray and Diagnostic Imaging Data Not Available

Health Management Programs

Asthma Available
Depression Not available
Diabetes Available
Heart Disease Not available
High Blood Pressure / High Cholesterol Available
Lower Back Pain Not available
Pain Management Not available
Pregnancy Available
Weight Loss Available

Other

Mental / Behavioral Health Inpatient No charge after deductible
Mental / Behavioral Health Outpatient Data Not Available
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 Data Not Available
Preferred Brand Rx Data Not Available
Non Preferred Brand Rx Data Not Available
Specialty Drugs

Other Plans in Michigan

Plan Totally You - Simple Choice Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Totally You Deductible $4,250 Coinsurance Not applicable Out of Pocket $7,350
Plan Totally You - Complete Deductible $3,750 Coinsurance Not applicable Out of Pocket $6,000
Plan Total Saver Plus Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Totally You - Value Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Total Saver Complete Deductible $7,150 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) $1,000
Deductible (Family) $2,000
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 No charge after deductible
Inpatient Physician No charge 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 after deductible
X-Ray and Diagnostic Imaging Data Not Available

Health Management Programs

Asthma Available
Depression Not available
Diabetes Available
Heart Disease Not available
High Blood Pressure / High Cholesterol Available
Lower Back Pain Not available
Pain Management Not available
Pregnancy Available
Weight Loss Available

Other

Mental / Behavioral Health Inpatient No charge after deductible
Mental / Behavioral Health Outpatient Data Not Available
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 Data Not Available
Preferred Brand Rx Data Not Available
Non Preferred Brand Rx Data Not Available
Specialty Drugs

Other Plans in Michigan

Plan Totally You - Simple Choice Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Totally You Deductible $4,250 Coinsurance Not applicable Out of Pocket $7,350
Plan Totally You - Complete Deductible $3,750 Coinsurance Not applicable Out of Pocket $6,000
Plan Total Saver Plus Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Totally You - Value Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Total Saver Complete Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150