More Information
Health Insurance Tools
Health Exchange Guides
- What is a Health Insurance Exchange?
- Understanding the ACA Subsidies
- Cost Sharing Reductions
- Minimum Essential Coverage
- What Is An Insurance Rating Area?
- The Individual Mandate and Penalties
- Inpatient vs Outpatient Care and Coverage
- Copay vs Coinsurance
- Average Cost of Health Insurance
- How Age Affects Your Health Insurance Costs
Visualizations and Data
Other Insurance Research
Geisinger - Geisinger Marketplace HMO 20/40/3000
Pennsylvania, 2018
Plan Type
HMO
Metal Tier
Gold
Out of Pocket Maximum
$7,350
Deductible
$3,000
Emergency Room Care: Data Not Available
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) | $3,000 |
|---|---|
| Deductible (Family) | $6,000 |
| Coinsurance | Not applicable |
| Out of Pocket Maximum (Individual) | $7,350 |
| Out of Pocket Maximum (Family) | $14,700 |
Doctor Visits
| Primary Care Visit | Data Not Available |
|---|---|
| Specialist Visit | Data Not Available |
| Inpatient Facility | $250 Copay per stay after deductible |
| Inpatient Physician | 20% Coinsurance after deductible |
| Emergency Room Services | Data Not Available |
Tests and Imaging
| Imaging (CT/PET Scans, MRIs) | Data Not Available |
|---|---|
| Laboratory Outpatient and Professional Services | Data Not Available |
| X-Ray and Diagnostic Imaging | Data Not Available |
Health Management Programs
| Asthma | Available |
|---|---|
| Depression | Available |
| Diabetes | Available |
| Heart Disease | Available |
| High Blood Pressure / High Cholesterol | Available |
| Lower Back Pain | Not available |
| Pain Management | Available |
| Pregnancy | Not available |
| Weight Loss | Available |
Other
| Mental / Behavioral Health Inpatient | $250 Copay per stay after deductible |
|---|---|
| Mental / Behavioral Health Outpatient | Data Not Available |
| Rehabilitative Speech Therapy | Data Not Available |
| Rehabilitative Occupational & Physical Therapy | Data Not Available |
| Outpatient Facility | 20% Coinsurance after deductible |
| Outpatient Surgery | $250 Copay 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 Pennsylvania
| Plan | Deductible | Coinsurance | Out of Pocket |
|---|---|---|---|
| Plan Geisinger Marketplace HMO 20/40/3000 | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace Value | Deductible $7,350 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace HMO 20/40/3000 | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace Value | Deductible $7,350 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace Select HMO 30/60/4650 | Deductible $4,650 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace HMO 20/40/3000 | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace HMO 30/60/6100 | Deductible $6,100 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace Extra HMO 10/50/4500 | Deductible $4,500 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace HMO 30/60/6100 | Deductible $6,100 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace HMO 30/60/6100 | Deductible $6,100 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace Extra HMO 10/50/500 | Deductible $500 | Coinsurance Not applicable | Out of Pocket $5,000 |
| Plan Geisinger Marketplace Select HMO 30/60/6100 | Deductible $6,100 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace Value | Deductible $7,350 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace Select HMO 20/40/3000 | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace Value | Deductible $7,350 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace HMO 30/60/4650 | Deductible $4,650 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace Extra HMO 10/50/4500 | Deductible $4,500 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace HMO 30/60/4650 | Deductible $4,650 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace HMO 30/60/4650 | Deductible $4,650 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace HMO 30/60/6100 | Deductible $6,100 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace HMO 30/60/4650 | Deductible $4,650 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace HMO 20/40/3000 | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace HMO 30/60/6100 | Deductible $6,100 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace Extra HMO 10/50/500 | Deductible $500 | Coinsurance Not applicable | Out of Pocket $5,000 |
| Plan Geisinger Marketplace HMO 30/60/4650 | Deductible $4,650 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan Geisinger Marketplace Value | Deductible $7,350 | Coinsurance Not applicable | Out of Pocket $7,350 |