Empower - Silver 2000/80

Individual Health Insurance (Obamacare)

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Benefits & Coverage

Plan Name
Empower - Silver 2000/80
Plan ID
87416WI0010014
Plan Year
2014
Insurance Type
Individual Health Insurance (Obamacare)
Insurance Provider
CGHC
Metal Level
Silver
Plan Type
PPO
Deductible
$2,000
Out-of-Pocket Maximum
$6,350
Plan Highlights

Cost & Coverage

Estimated Monthly Base Rate
Estimated monthly premium starts at $234.08
Deductible
Individual: $2000
Family: $4000
In-Network Out-of-Pocket Limit
Individual: $6350
Family: $12700
Is this plan Health Savings Account (HSA) eligible?
No
How can I find a doctor in this plan's network?
Plan Type
PPO

Health Services Options

Service
In Network
Out of Network
Primary care physician office visit
20% Coinsurance after deductible
Specialist
20% Coinsurance after deductible
Hospital facility fee
20% Coinsurance after deductible
Emergency Room
20% Coinsurance after deductible

Drug Services

Generic Drugs
Coverage: 20% Coinsurance after deductible
Specialty Drugs
Coverage: 20% Coinsurance after deductible
What drugs are covered in the formulary?

Mental Health or Substance Abuse Services

Service
In Network
Out of Network

Maternity Services

Service
In Network
Out of Network

Coverage Options Summary

Included Benefits
  • Non-preferred brand drugs

What To Know

  • This is an ACA (Obamacare) compliant health plan.
  • This plan is eligible for a tax credit subsidy

Physician Directory

List of doctors that accepts Empower - Silver 2000/80 Obamacare Plan in Wisconsin

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