Montana - Connected Care Silver

Montana, 2018

  • Plan Type

    PPO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $7,350

  • Deductible

    $2,450

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) $2,450
Deductible (Family) $4,900
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,350
Out of Pocket Maximum (Family) $14,700

Doctor Visits

Primary Care Visit $40 Copay after deductible
Specialist Visit $65 Copay after deductible
Inpatient Facility 40% Coinsurance after deductible
Inpatient Physician 40% Coinsurance after deductible
Emergency Room Services $200 Copay after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 40% Coinsurance after deductible
Laboratory Outpatient and Professional Services 40% Coinsurance after deductible
X-Ray and Diagnostic Imaging 40% 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 Not available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient 40% Coinsurance after deductible
Mental / Behavioral Health Outpatient $40 Copay after deductible
Rehabilitative Speech Therapy $65 Copay after deductible
Rehabilitative Occupational & Physical Therapy $65 Copay after deductible
Outpatient Facility 40% Coinsurance after deductible
Outpatient Surgery 40% 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

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) $2,150
Deductible (Family) $4,300
Out of Pocket Maximum (Individual) $5,200
Out of Pocket Maximum (Family) $10,400

Doctor Visits

Primary Care Physician $35 Copay after deductible
Specialists $65 Copay after deductible
Emergency Room $200 Copay after deductible
Inpatient Facility 40% Coinsurance after deductible
Inpatient Physician 40% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

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) $500
Deductible (Family) $1,000
Out of Pocket Maximum (Individual) $2,000
Out of Pocket Maximum (Family) $4,000

Doctor Visits

Primary Care Physician
Specialists $45 Copay after deductible
Emergency Room $150 Copay after deductible
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% 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) $0
Deductible (Family) $0
Out of Pocket Maximum (Individual) $800
Out of Pocket Maximum (Family) $1,600

Doctor Visits

Primary Care Physician
Specialists
Emergency Room
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 Montana

Plan Access Care Gold Deductible $800 Coinsurance Not applicable Out of Pocket $5,750
Plan Connected Care Catastrophic Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Connected Care Expanded Bronze Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,200
Plan Connected Care Gold Deductible $750 Coinsurance Not applicable Out of Pocket $5,000
Plan Access Care Silver Deductible $2,450 Coinsurance Not applicable Out of Pocket $7,350
Plan Connected Care Bronze Deductible $7,200 Coinsurance Not applicable Out of Pocket $7,350
Plan Connected Care Silver Option 2 Deductible $5,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Access Care Bronze Plus Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Access Care Expanded Bronze Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,800
Plan Connected Care Bronze Plus Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Access Care Bronze Deductible $7,200 Coinsurance Not applicable Out of Pocket $7,350
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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) $2,450
Deductible (Family) $4,900
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,350
Out of Pocket Maximum (Family) $14,700

Doctor Visits

Primary Care Visit $40 Copay after deductible
Specialist Visit $65 Copay after deductible
Inpatient Facility 40% Coinsurance after deductible
Inpatient Physician 40% Coinsurance after deductible
Emergency Room Services $200 Copay after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 40% Coinsurance after deductible
Laboratory Outpatient and Professional Services 40% Coinsurance after deductible
X-Ray and Diagnostic Imaging 40% 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 Not available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient 40% Coinsurance after deductible
Mental / Behavioral Health Outpatient $40 Copay after deductible
Rehabilitative Speech Therapy $65 Copay after deductible
Rehabilitative Occupational & Physical Therapy $65 Copay after deductible
Outpatient Facility 40% Coinsurance after deductible
Outpatient Surgery 40% 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

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) $2,150
Deductible (Family) $4,300
Out of Pocket Maximum (Individual) $5,200
Out of Pocket Maximum (Family) $10,400

Doctor Visits

Primary Care Physician $35 Copay after deductible
Specialists $65 Copay after deductible
Emergency Room $200 Copay after deductible
Inpatient Facility 40% Coinsurance after deductible
Inpatient Physician 40% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

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) $500
Deductible (Family) $1,000
Out of Pocket Maximum (Individual) $2,000
Out of Pocket Maximum (Family) $4,000

Doctor Visits

Primary Care Physician
Specialists $45 Copay after deductible
Emergency Room $150 Copay after deductible
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% 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) $0
Deductible (Family) $0
Out of Pocket Maximum (Individual) $800
Out of Pocket Maximum (Family) $1,600

Doctor Visits

Primary Care Physician
Specialists
Emergency Room
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 Montana

Plan Access Care Gold Deductible $800 Coinsurance Not applicable Out of Pocket $5,750
Plan Connected Care Catastrophic Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Connected Care Expanded Bronze Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,200
Plan Connected Care Gold Deductible $750 Coinsurance Not applicable Out of Pocket $5,000
Plan Access Care Silver Deductible $2,450 Coinsurance Not applicable Out of Pocket $7,350
Plan Connected Care Bronze Deductible $7,200 Coinsurance Not applicable Out of Pocket $7,350
Plan Connected Care Silver Option 2 Deductible $5,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Access Care Bronze Plus Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Access Care Expanded Bronze Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,800
Plan Connected Care Bronze Plus Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Access Care Bronze Deductible $7,200 Coinsurance Not applicable Out of Pocket $7,350