Sanford - Sanford TRUE $4,000 HSA/HDHP

North Dakota, 2018

  • Plan Type

    HMO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $4,000

  • Deductible

    $4,000

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) $4,000
Deductible (Family) $8,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $4,000
Out of Pocket Maximum (Family) $8,000

Doctor Visits

Primary Care Visit 0% Coinsurance after deductible
Specialist Visit 0% Coinsurance after deductible
Inpatient Facility 0% Coinsurance after deductible
Inpatient Physician 0% Coinsurance after deductible
Emergency Room Services 0% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 0% Coinsurance after deductible
Laboratory Outpatient and Professional Services 0% Coinsurance after deductible
X-Ray and Diagnostic Imaging 0% Coinsurance after deductible

Health Management Programs

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

Other

Mental / Behavioral Health Inpatient 0% Coinsurance after deductible
Mental / Behavioral Health Outpatient 0% Coinsurance after deductible
Rehabilitative Speech Therapy 0% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 0% Coinsurance after deductible
Outpatient Facility 0% Coinsurance after deductible
Outpatient Surgery 0% Coinsurance after deductible

Prescription Drugs

Generic Rx 0% Coinsurance after deductible
Preferred Brand Rx 0% Coinsurance after deductible
Non Preferred Brand Rx 0% Coinsurance after deductible
Specialty Drugs 0% 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) $3,500
Deductible (Family) $7,000
Out of Pocket Maximum (Individual) $3,500
Out of Pocket Maximum (Family) $7,000

Doctor Visits

Primary Care Physician 0% Coinsurance after deductible
Specialists 0% Coinsurance after deductible
Emergency Room 0% Coinsurance after deductible
Inpatient Facility 0% Coinsurance after deductible
Inpatient Physician 0% Coinsurance after deductible

Prescription Drugs

Generic Rx 0% Coinsurance after deductible
Preferred Brand Rx 0% Coinsurance after deductible
Non Preferred Brand Rx 0% Coinsurance after deductible
Specialty Drugs 0% 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) $1,250
Deductible (Family) $2,500
Out of Pocket Maximum (Individual) $1,250
Out of Pocket Maximum (Family) $2,500

Doctor Visits

Primary Care Physician 0% Coinsurance after deductible
Specialists 0% Coinsurance after deductible
Emergency Room 0% Coinsurance after deductible
Inpatient Facility 0% Coinsurance after deductible
Inpatient Physician 0% Coinsurance after deductible

Prescription Drugs

Generic Rx 0% Coinsurance after deductible
Preferred Brand Rx 0% Coinsurance after deductible
Non Preferred Brand Rx 0% Coinsurance after deductible
Specialty Drugs 0% Coinsurance after deductible

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) $550
Deductible (Family) $1,100
Out of Pocket Maximum (Individual) $550
Out of Pocket Maximum (Family) $1,100

Doctor Visits

Primary Care Physician 0% Coinsurance after deductible
Specialists 0% Coinsurance after deductible
Emergency Room 0% Coinsurance after deductible
Inpatient Facility 0% Coinsurance after deductible
Inpatient Physician 0% Coinsurance after deductible

Prescription Drugs

Generic Rx 0% Coinsurance after deductible
Preferred Brand Rx 0% Coinsurance after deductible
Non Preferred Brand Rx 0% Coinsurance after deductible
Specialty Drugs 0% Coinsurance after deductible

Other Plans in North Dakota

Plan Sanford TRUE $6,000 Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Sanford TRUE $4,750 Deductible $4,750 Coinsurance Not applicable Out of Pocket $7,350
Plan Sanford TRUE $2,800 Deductible $2,800 Coinsurance Not applicable Out of Pocket $7,350
Plan Sanford TRUE $7,350 Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Sanford TRUE $3,500 Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Sanford TRUE $5,000 HSA/HDHP Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,550
Plan Sanford TRUE $1,250 Deductible $1,250 Coinsurance Not applicable Out of Pocket $4,750
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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) $4,000
Deductible (Family) $8,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $4,000
Out of Pocket Maximum (Family) $8,000

Doctor Visits

Primary Care Visit 0% Coinsurance after deductible
Specialist Visit 0% Coinsurance after deductible
Inpatient Facility 0% Coinsurance after deductible
Inpatient Physician 0% Coinsurance after deductible
Emergency Room Services 0% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 0% Coinsurance after deductible
Laboratory Outpatient and Professional Services 0% Coinsurance after deductible
X-Ray and Diagnostic Imaging 0% Coinsurance after deductible

Health Management Programs

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

Other

Mental / Behavioral Health Inpatient 0% Coinsurance after deductible
Mental / Behavioral Health Outpatient 0% Coinsurance after deductible
Rehabilitative Speech Therapy 0% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 0% Coinsurance after deductible
Outpatient Facility 0% Coinsurance after deductible
Outpatient Surgery 0% Coinsurance after deductible

Prescription Drugs

Generic Rx 0% Coinsurance after deductible
Preferred Brand Rx 0% Coinsurance after deductible
Non Preferred Brand Rx 0% Coinsurance after deductible
Specialty Drugs 0% 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) $3,500
Deductible (Family) $7,000
Out of Pocket Maximum (Individual) $3,500
Out of Pocket Maximum (Family) $7,000

Doctor Visits

Primary Care Physician 0% Coinsurance after deductible
Specialists 0% Coinsurance after deductible
Emergency Room 0% Coinsurance after deductible
Inpatient Facility 0% Coinsurance after deductible
Inpatient Physician 0% Coinsurance after deductible

Prescription Drugs

Generic Rx 0% Coinsurance after deductible
Preferred Brand Rx 0% Coinsurance after deductible
Non Preferred Brand Rx 0% Coinsurance after deductible
Specialty Drugs 0% 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) $1,250
Deductible (Family) $2,500
Out of Pocket Maximum (Individual) $1,250
Out of Pocket Maximum (Family) $2,500

Doctor Visits

Primary Care Physician 0% Coinsurance after deductible
Specialists 0% Coinsurance after deductible
Emergency Room 0% Coinsurance after deductible
Inpatient Facility 0% Coinsurance after deductible
Inpatient Physician 0% Coinsurance after deductible

Prescription Drugs

Generic Rx 0% Coinsurance after deductible
Preferred Brand Rx 0% Coinsurance after deductible
Non Preferred Brand Rx 0% Coinsurance after deductible
Specialty Drugs 0% Coinsurance after deductible

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) $550
Deductible (Family) $1,100
Out of Pocket Maximum (Individual) $550
Out of Pocket Maximum (Family) $1,100

Doctor Visits

Primary Care Physician 0% Coinsurance after deductible
Specialists 0% Coinsurance after deductible
Emergency Room 0% Coinsurance after deductible
Inpatient Facility 0% Coinsurance after deductible
Inpatient Physician 0% Coinsurance after deductible

Prescription Drugs

Generic Rx 0% Coinsurance after deductible
Preferred Brand Rx 0% Coinsurance after deductible
Non Preferred Brand Rx 0% Coinsurance after deductible
Specialty Drugs 0% Coinsurance after deductible

Other Plans in North Dakota

Plan Sanford TRUE $6,000 Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Sanford TRUE $4,750 Deductible $4,750 Coinsurance Not applicable Out of Pocket $7,350
Plan Sanford TRUE $2,800 Deductible $2,800 Coinsurance Not applicable Out of Pocket $7,350
Plan Sanford TRUE $7,350 Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Sanford TRUE $3,500 Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Sanford TRUE $5,000 HSA/HDHP Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,550
Plan Sanford TRUE $1,250 Deductible $1,250 Coinsurance Not applicable Out of Pocket $4,750