2019 Complete HMO HSA 2000 25/50 Plan Details - HealthPocket

Complete HMO HSA 2000 25/50

$411.52/mo

Apply For This Plan

Zip Code02128
Applicant10/18/1984 Male
Coverage Start10/19/2019
Apply Now

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameComplete HMO HSA 2000 25/50
Plan IDhhs-41304MA0021275
Plan Year2019
Insurance ProviderAllWays Health Partners
Metal LevelSilver
Plan TypeHMO
Deductible$2,000
Out-of-Pocket Maximum$6,700
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$25 Copay after deductible
Specialist Visit$50 Copay after deductible
Laboratory Outpatient and Professional Services$50 Copay after deductible
X-rays and Diagnostic Imaging$50 Copay after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans$250 Copay after deductible
Deductible - Family$4000 per group
Out-of-Pocket Maximum - Family$13400 per group

Prescription drug coverage

Generic Drugs$25 Copay after deductible
Preferred Brand Drugs$50 Copay after deductible
Non-Preferred Brand Drugs$100 Copay after deductible
Specialty Drugs$100 Copay after deductible

Access to doctors and hospitals

Provider directory URLhttps://www.allwayshealthpartners.org
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?Yes - All except: Gynecologist or Obstetrician for routine, preventive or urgent care; Family Planning services; Outpatient and Diversionary Behavioral Health Services; Routine Eye Exam; Physical Therapy; Occupational Therapy; Speech Therapy and Emergency Services.
Does this plan cover services outside plan service area?Yes - Urgent and Emergency only
Does this plan cover services outside the country?Yes - Urgent and Emergency only

Hospital services

Emergency Room Services$250 Copay after deductible
Inpatient Hospital Services (e.g., Hospital Stay)$500 Copay per Stay after deductible
Inpatient Physician and Surgical ServicesNot Applicable
Emergency Transportation or Ambulance ServiceNot Applicable

Maternity

Prenatal and Postnatal CareNot Applicable
Delivery and all inpatient services for maternity care$500 Copay after deductible

Mental Health

Mental/Behavioral Health Outpatient Services$25 Copay after deductible
Mental/Behavioral Health Inpatient Services$500 Copay per Stay after deductible
Substance use disorder outpatient services$25 Copay after deductible
Substance use disorder inpatient services$500 Copay per Stay after deductible

Medical Management Programs

Does this plan offer disease managment programs?Asthma, Depression, Diabetes, Heart Disease, Pain Management, Pregnancy, Weight Loss Programs
Does this plan offer a wellness program?Included

Vision Coverage

Routine Eye Exam for ChildrenIncluded
Eye Glasses for ChildrenIncluded
Routine Eye Exam for AdultsIncluded

Child Dental Coverage

Child Dental Coverage - Routine Dental CareIncluded
Child Dental Coverage - Basic Dental CareIncluded
Child Dental Coverage - OrthodontiaIncluded
Child Dental Coverage - Major Dental CareIncluded

Adult Dental Coverage

Adult Dental Coverage - Routine Dental CareNot Covered
Adult Dental Coverage - Basic Dental CareNot Covered
Adult Dental Coverage - OrthodontiaNot Covered
Adult Dental Coverage - Major Dental CareNot Covered

Exclusions and Limitations

More Included BenefitsOther Practitioner Office Visit (Nurse, Physician Assistant)
Bariatric Surgery
Infertility Treatment
Imaging (CT/PET Scans, MRIs)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Home Health Care Services
Durable Medical Equipment
Hospice Services
Chiropractic Care
Routine Foot Care
Abortion for Which Public Funding is Prohibited
Accidental Dental
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Rehabilitative Speech Therapy
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
More Limited BenefitsPreventive Care/Screening/Immunization
Skilled Nursing Facility
Hearing Aids
Weight Loss Programs
Outpatient Rehabilitation Services
Habilitation Services
Dental Check-Up for Children
Rehabilitative Occupational and Rehabilitative Physical Therapy
More Excluded BenefitsAcupuncture
Cosmetic Surgery
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
PremiumPlan NameDeductible
from $302
Standard Silver: Tufts Health Direct Silver 2000 II
$2,000.00Select
from $367
Standard Low Gold: Tufts Health Direct Gold 2000
$2,000.00Select
from $372
Choice Easy Tier HMO 2000 15%/35%
$2,000.00Select
from $397
Complete HMO 2000 35%
$2,000.00Select
from $402
Complete HMO 2000 25/50
$2,000.00Select
/
Please select the correct zip
Jackie, Fantes
View All Details
Loretta, Chou
View All Details
Jan, Dohlman
View All Details
Charles, Williams
View All Details
Mirjana, Kostich
View All Details
Courtney, Robertson
View All Details
Gina, Campanella
View All Details
Jacklyn, Giampa
View All Details
Mary, Gallagher
View All Details
Meghan, Riedy
View All Details
Victoria, Shopland
View All Details
Nairoby, Nunez
View All Details
Jessica, Maclean
View All Details
Julia, Bird
View All Details
Alison, Carr
View All Details
Kelly, Trussell
View All Details
Adrianna, D'aurora
View All Details
East Boston Physical Therapy Center, Inc.
View All Details
Marissa, Gonzalez
View All Details
Maureen, Young
View All Details
Caroline, Del Rey
View All Details
Jackie Fantes, MD
View All Details
  • Phone Number
    (617) 569-5800
  • Office Locations
    10 Gove St
    East Boston, MA 02128
10 Gove St East Boston MA, 02128
  • What Is the Silver Plan?

    ObamaCare’s Silver Plan is a type of Metal Plan on the Health Insurance Marketplace. Silver Plans qualify for both Tax Credits and Cost Sharing subsidies.Silver Plans have lower out-of-pocket costs than Bronze Plans but higher out- of-pocket costs than both Gold and Platinum Plans. All Silver Plans share the same minimum health benefits, but the way they charge out-of-pocket costs can differ significantly.

  • How are Silver Plans different than other Obamacare health plans?

    The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Silver Plan pays 70% of covered medical costs for a typical enrollee. Silver Plans are also the only metal plans which offer cost-sharing reduction (CSR) versions to consumers that require financial assistance for out-of-pocket costs.

  • How much does a Silver Plan cost?

    The monthly premium for a Silver Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and the region in which you live. You can use HealthPocket’s comparison tool to compare Silver Plan premiums in your area.

  • When Can I Enroll in a Silver Plan?

    The Open Enrollment period for the 2018 Affordable Care Act health plans begins November 1, 2017 and ends December 15, 2017. See our Open Enrollment article for more information.

Read More

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).

Close

Health Plans Found

 

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).