IHC Select Silver HMO Local Value $50/$75 Plan Details for 2021- HealthPocket

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Zip Code	08701 (edit)
Applicant	1/18/1986 Male (edit)

Insurance Type	ACA (Obamacare)
Plan Name	IHC Select Silver HMO Local Value $50/$75
Plan ID	hhs-77606NJ0040070
Plan Year	2020
Insurance Provider	AmeriHealth
Metal Level	Silver
Plan Type	HMO
Deductible	$2,500
Out-of-Pocket Maximum	$8,000
Plan Highlights

Costs for Medical Care
Primary Care Visit to Treat an Injury or Illness	$50 Copay
Specialist Visit	$75 Copay
Laboratory Outpatient and Professional Services	Not Applicable
X-rays and Diagnostic Imaging	$50 Copay
Diagnostic Imaging such as MRIs, CT, and PET scans	$100 Copay
Deductible - Family	$5000 per group
Out-of-Pocket Maximum - Family	$16000 per group

Prescription drug coverage
Generic Drugs	$15 Copay
Preferred Brand Drugs	50.00% Coinsurance after deductible
Non-Preferred Brand Drugs	50.00% Coinsurance after deductible
Specialty Drugs	50.00% Coinsurance after deductible

Access to doctors and hospitals
Provider directory URL	http://www.amerihealthnj.com/provider_finder
Does this plan have access to a national provider network?	No
Is a referral required to see a Specialist?	Yes - All Specialist
Does this plan cover services outside plan service area?	Yes - Emergency Care is covered outside of the service area.
Does this plan cover services outside the country?	Not Covered

Hospital services
Emergency Room Services	$100 Copay after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	50.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	50.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service	50.00% Coinsurance after deductible

Maternity
Prenatal and Postnatal Care	Not Applicable
Delivery and all inpatient services for maternity care	50.00% Coinsurance after deductible

Mental Health
Mental/Behavioral Health Outpatient Services	$70 Copay
Mental/Behavioral Health Inpatient Services	50.00% Coinsurance after deductible
Substance use disorder outpatient services	$70 Copay
Substance use disorder inpatient services	50.00% Coinsurance after deductible

Medical Management Programs
Does this plan offer disease managment programs?	Asthma, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Pregnancy
Does this plan offer a wellness program?	Not Covered

Vision Coverage
Routine Eye Exam for Children	Included
Eye Glasses for Children	Included
Routine Eye Exam for Adults	Not Covered

Child Dental Coverage
Child Dental Coverage - Routine Dental Care	Not Covered
Child Dental Coverage - Basic Dental Care	Not Covered
Child Dental Coverage - Orthodontia	Not Covered
Child Dental Coverage - Major Dental Care	Not Covered

Adult Dental Coverage
Adult Dental Coverage - Routine Dental Care	Not Covered
Adult Dental Coverage - Basic Dental Care	Not Covered
Adult Dental Coverage - Orthodontia	Not Covered
Adult Dental Coverage - Major Dental Care	Not Covered

Exclusions and Limitations
More Included Benefits	Other Practitioner Office Visit (Nurse, Physician Assistant) Preventive Care/Screening/Immunization Skilled Nursing Facility Bariatric Surgery Infertility Treatment Private-Duty Nursing 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 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 Transplant Treatment for Temporomandibular Joint Disorders Well Baby Visits and Care Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
More Limited Benefits	Hearing Aids Outpatient Rehabilitation Services Habilitation Services Chiropractic Care Rehabilitative Occupational and Rehabilitative Physical Therapy Rehabilitative Speech Therapy
More Excluded Benefits	Acupuncture Cosmetic Surgery Long-Term/Custodial Nursing Home Care Weight Loss Programs Dental Check-Up for Children Routine Foot Care

+ See All Coverage Details

Premium	Plan Name	Deductible
from $399	Oscar Silver Classic Off-Ex	$2,500.00	Select
from $433	Oscar Silver Saver (Free 24/7 Virtual Visits + Free Personal Ca	$2,500.00	Select
from $450	Oscar Silver Classic (Free 24/7 Virtual Visits + Free Personal	$2,500.00	Select
from $503	IHC Silver EPO Local Value $50/$75	$2,500.00	Select

Last Name

Location/Distance

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Ruchama, Schulman

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Yitzchok, Markovitz

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Mr Therapy Llc

Rebecca, Bamberger

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Michael, Bunzel

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Jeffrey Kaminetzky, M.D.

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Phone Number
(732) 364-2144
Office Locations
1771 Madison Ave
Lakewood, NJ 08701

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.

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 Benefytt Technologies, Inc. family of companies.

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Date of birth
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Income
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IHC Select Silver HMO Local Value $50/$75

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Benefits & Coverage

Costs for Medical Care

Prescription drug coverage

Access to doctors and hospitals

Hospital services

Maternity

Mental Health

Medical Management Programs

Vision Coverage

Child Dental Coverage

Adult Dental Coverage

Exclusions and Limitations

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