Physicians - Sparrow PHP Silver 3200 H.S.A. Exclusive

Michigan, 2019

  • Plan Type

    HMO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $6,650

  • Deductible

    $3,200

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) $3,200
Deductible (Family) $6,400
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,650
Out of Pocket Maximum (Family) $13,300

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 Not available
High Blood Pressure / High Cholesterol Not available
Lower Back Pain Not available
Pain Management Not available
Pregnancy Available
Weight Loss 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 $30 Copay after deductible
Preferred Brand Rx $65 Copay after deductible
Non Preferred Brand Rx $150 Copay after deductible
Specialty Drugs $200 Copay 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) $3,000
Deductible (Family) $6,000
Out of Pocket Maximum (Individual) $5,000
Out of Pocket Maximum (Family) $10,000

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 $20 Copay after deductible
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx $80 Copay after deductible
Specialty Drugs $150 Copay 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) $1,000
Deductible (Family) $2,000
Out of Pocket Maximum (Individual) $2,000
Out of Pocket Maximum (Family) $4,000

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 $5 Copay after deductible
Preferred Brand Rx $20 Copay after deductible
Non Preferred Brand Rx $50 Copay after deductible
Specialty Drugs $100 Copay 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) $300
Deductible (Family) $600
Out of Pocket Maximum (Individual) $600
Out of Pocket Maximum (Family) $1,200

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 $5 Copay after deductible
Preferred Brand Rx $20 Copay after deductible
Non Preferred Brand Rx $50 Copay after deductible
Specialty Drugs $100 Copay after deductible

Other Plans in Michigan

Plan Sparrow PHP Bronze 6650 H.S.A. Exclusive Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Sparrow PHP Silver 7000 Exclusive Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Sparrow PHP Bronze 5500 H.S.A. Exclusive Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,650
Plan Sparrow PHP Silver 4000 HMO Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Gold 500 HMO Deductible $500 Coinsurance Not applicable Out of Pocket $6,500
Plan Sparrow PHP Gold 2000 Exclusive Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,800
Plan Sparrow PHP Bronze 6650 H.S.A. HMO Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Sparrow PHP Healthy HMO Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Sparrow PHP Silver 2500 Basic Exclusive Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Sparrow PHP Gold 500 Exclusive Deductible $500 Coinsurance Not applicable Out of Pocket $6,500
Plan Sparrow PHP Silver 4000 Exclusive Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Platinum 500 Exclusive Deductible $500 Coinsurance Not applicable Out of Pocket $2,300
Plan Sparrow PHP Silver 2000 Exclusive Deductible $2,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Sparrow PHP Gold 1500 Exclusive Deductible $1,500 Coinsurance Not applicable Out of Pocket $5,000
Plan Sparrow PHP Platinum 500 HMO Deductible $500 Coinsurance Not applicable Out of Pocket $2,300
Plan Sparrow PHP Gold 1600 H.S.A. Exclusive Deductible $1,600 Coinsurance Not applicable Out of Pocket $3,000
Plan Sparrow PHP Bronze 7300 Exclusive Deductible $7,300 Coinsurance Not applicable Out of Pocket $7,900
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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) $3,200
Deductible (Family) $6,400
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,650
Out of Pocket Maximum (Family) $13,300

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 Not available
High Blood Pressure / High Cholesterol Not available
Lower Back Pain Not available
Pain Management Not available
Pregnancy Available
Weight Loss 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 $30 Copay after deductible
Preferred Brand Rx $65 Copay after deductible
Non Preferred Brand Rx $150 Copay after deductible
Specialty Drugs $200 Copay 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) $3,000
Deductible (Family) $6,000
Out of Pocket Maximum (Individual) $5,000
Out of Pocket Maximum (Family) $10,000

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 $20 Copay after deductible
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx $80 Copay after deductible
Specialty Drugs $150 Copay 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) $1,000
Deductible (Family) $2,000
Out of Pocket Maximum (Individual) $2,000
Out of Pocket Maximum (Family) $4,000

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 $5 Copay after deductible
Preferred Brand Rx $20 Copay after deductible
Non Preferred Brand Rx $50 Copay after deductible
Specialty Drugs $100 Copay 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) $300
Deductible (Family) $600
Out of Pocket Maximum (Individual) $600
Out of Pocket Maximum (Family) $1,200

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 $5 Copay after deductible
Preferred Brand Rx $20 Copay after deductible
Non Preferred Brand Rx $50 Copay after deductible
Specialty Drugs $100 Copay after deductible

Other Plans in Michigan

Plan Sparrow PHP Bronze 6650 H.S.A. Exclusive Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Sparrow PHP Silver 7000 Exclusive Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Sparrow PHP Bronze 5500 H.S.A. Exclusive Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,650
Plan Sparrow PHP Silver 4000 HMO Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Gold 500 HMO Deductible $500 Coinsurance Not applicable Out of Pocket $6,500
Plan Sparrow PHP Gold 2000 Exclusive Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,800
Plan Sparrow PHP Bronze 6650 H.S.A. HMO Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Sparrow PHP Healthy HMO Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Sparrow PHP Silver 2500 Basic Exclusive Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Sparrow PHP Gold 500 Exclusive Deductible $500 Coinsurance Not applicable Out of Pocket $6,500
Plan Sparrow PHP Silver 4000 Exclusive Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Sparrow PHP Platinum 500 Exclusive Deductible $500 Coinsurance Not applicable Out of Pocket $2,300
Plan Sparrow PHP Silver 2000 Exclusive Deductible $2,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Sparrow PHP Gold 1500 Exclusive Deductible $1,500 Coinsurance Not applicable Out of Pocket $5,000
Plan Sparrow PHP Platinum 500 HMO Deductible $500 Coinsurance Not applicable Out of Pocket $2,300
Plan Sparrow PHP Gold 1600 H.S.A. Exclusive Deductible $1,600 Coinsurance Not applicable Out of Pocket $3,000
Plan Sparrow PHP Bronze 7300 Exclusive Deductible $7,300 Coinsurance Not applicable Out of Pocket $7,900