Health - HMO 4000b OSF Silver

Illinois, 2019

  • Plan Type

    HMO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $7,500

  • 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) $7,500
Out of Pocket Maximum (Family) $15,000

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility $750 Copay per day
Inpatient Physician 30% Coinsurance after deductible
Emergency Room Services 30% Coinsurance after deductible

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

Other

Mental / Behavioral Health Inpatient $750 Copay per day
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy Data Not Available
Rehabilitative Occupational & Physical Therapy Data Not Available
Outpatient Facility Data Not Available
Outpatient Surgery Data Not Available

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) $3,600
Deductible (Family) $7,200
Out of Pocket Maximum (Individual) $6,300
Out of Pocket Maximum (Family) $12,600

Doctor Visits

Primary Care Physician
Specialists
Emergency Room 30% Coinsurance after deductible
Inpatient Facility $600 Copay per day
Inpatient Physician 30% 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) $2,600
Out of Pocket Maximum (Family) $5,200

Doctor Visits

Primary Care Physician
Specialists
Emergency Room 0% Coinsurance after deductible
Inpatient Facility $200 Copay per day
Inpatient Physician 0% 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) $250
Deductible (Family) $500
Out of Pocket Maximum (Individual) $1,750
Out of Pocket Maximum (Family) $3,500

Doctor Visits

Primary Care Physician
Specialists
Emergency Room 0% Coinsurance after deductible
Inpatient Facility $25 Copay per day
Inpatient Physician 0% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

Other Plans in Illinois

Plan POS HSA 6650 Elite Bronze Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan POS 7250 Riverside Silver Deductible $7,250 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 3150 OSF Silver Deductible $3,150 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 5000c OSF Silver Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,300
Plan HMO 3500a Elite Silver Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 3500a OSF Silver Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan POS 5000a Elite Bronze Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 5000c Elite Silver Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,300
Plan POS 5000a OSF Bronze Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 4000b Elite Silver Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,500
Plan HMO 7900 Elite Catastrophic Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 3800 Elite Bronze Deductible $3,800 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 2000 Methodist Gold Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,000
Plan POS 7250 Elite Silver Deductible $7,250 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 5000c Methodist Silver Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,300
Plan POS 6000a Methodist Bronze Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan POS 5000a Methodist Bronze Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 3500a Methodist Silver Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 4000b Methodist Silver Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,500
Plan POS HSA 6650 Methodist Bronze Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan POS 6000a OSF Bronze Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 3150 Methodist Silver Deductible $3,150 Coinsurance Not applicable Out of Pocket $7,900
Plan POS 7250 OSF Silver Deductible $7,250 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 3800 OSF Bronze Deductible $3,800 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 2000 Elite Gold Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,000
Plan HMO 3150 Elite Silver Deductible $3,150 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 3800 Methodist Bronze Deductible $3,800 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 2000 OSF Gold Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,000
Plan POS 7250 Methodist Silver Deductible $7,250 Coinsurance Not applicable Out of Pocket $7,900
Plan POS 6000a Elite Bronze Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan POS HSA 6650 OSF Bronze Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
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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) $7,500
Out of Pocket Maximum (Family) $15,000

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility $750 Copay per day
Inpatient Physician 30% Coinsurance after deductible
Emergency Room Services 30% Coinsurance after deductible

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

Other

Mental / Behavioral Health Inpatient $750 Copay per day
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy Data Not Available
Rehabilitative Occupational & Physical Therapy Data Not Available
Outpatient Facility Data Not Available
Outpatient Surgery Data Not Available

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) $3,600
Deductible (Family) $7,200
Out of Pocket Maximum (Individual) $6,300
Out of Pocket Maximum (Family) $12,600

Doctor Visits

Primary Care Physician
Specialists
Emergency Room 30% Coinsurance after deductible
Inpatient Facility $600 Copay per day
Inpatient Physician 30% 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) $2,600
Out of Pocket Maximum (Family) $5,200

Doctor Visits

Primary Care Physician
Specialists
Emergency Room 0% Coinsurance after deductible
Inpatient Facility $200 Copay per day
Inpatient Physician 0% 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) $250
Deductible (Family) $500
Out of Pocket Maximum (Individual) $1,750
Out of Pocket Maximum (Family) $3,500

Doctor Visits

Primary Care Physician
Specialists
Emergency Room 0% Coinsurance after deductible
Inpatient Facility $25 Copay per day
Inpatient Physician 0% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

Other Plans in Illinois

Plan POS HSA 6650 Elite Bronze Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan POS 7250 Riverside Silver Deductible $7,250 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 3150 OSF Silver Deductible $3,150 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 5000c OSF Silver Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,300
Plan HMO 3500a Elite Silver Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 3500a OSF Silver Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan POS 5000a Elite Bronze Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 5000c Elite Silver Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,300
Plan POS 5000a OSF Bronze Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 4000b Elite Silver Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,500
Plan HMO 7900 Elite Catastrophic Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 3800 Elite Bronze Deductible $3,800 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 2000 Methodist Gold Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,000
Plan POS 7250 Elite Silver Deductible $7,250 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 5000c Methodist Silver Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,300
Plan POS 6000a Methodist Bronze Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan POS 5000a Methodist Bronze Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 3500a Methodist Silver Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 4000b Methodist Silver Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,500
Plan POS HSA 6650 Methodist Bronze Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan POS 6000a OSF Bronze Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 3150 Methodist Silver Deductible $3,150 Coinsurance Not applicable Out of Pocket $7,900
Plan POS 7250 OSF Silver Deductible $7,250 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 3800 OSF Bronze Deductible $3,800 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 2000 Elite Gold Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,000
Plan HMO 3150 Elite Silver Deductible $3,150 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 3800 Methodist Bronze Deductible $3,800 Coinsurance Not applicable Out of Pocket $7,900
Plan HMO 2000 OSF Gold Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,000
Plan POS 7250 Methodist Silver Deductible $7,250 Coinsurance Not applicable Out of Pocket $7,900
Plan POS 6000a Elite Bronze Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan POS HSA 6650 OSF Bronze Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650