LifeWise Primary Silver Plan Details for 2021- HealthPocket

ZIP Code
County
Applicant Info
Applicant
Date of birth
//
Gender
male
female
Income
$

Apply For This Plan

Zip Code	98115 (edit)
Applicant	3/1/1986 Male (edit)

Apply Now

Insurance Type	ACA (Obamacare)
Plan Name	LifeWise Primary Silver
Plan ID	hhs-38498WA0320007
Plan Year	2021
Insurance Provider	LifeWise Health Plan of Washington
Metal Level	Silver
Plan Type	EPO
Deductible	$3,000
Out-of-Pocket Maximum	$8,150
Plan Highlights

Costs for Medical Care
Primary Care Visit to Treat an Injury or Illness	$30 Copay
Specialist Visit	$60 Copay
Laboratory Outpatient and Professional Services	30.00% Coinsurance after deductible
X-rays and Diagnostic Imaging	30.00% Coinsurance after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans	30.00% Coinsurance after deductible
Deductible - Family	$6000 per group
Out-of-Pocket Maximum - Family	$16300 per group

Prescription drug coverage
Generic Drugs	$20 Copay
Preferred Brand Drugs	30.00% Coinsurance after deductible
Non-Preferred Brand Drugs	30.00% Coinsurance after deductible
Specialty Drugs	50.00% Coinsurance after deductible

Access to doctors and hospitals
Provider directory URL	https://lifewise.sapphirecareselect.com/?ci=lifewisewa&network_id=21
Does this plan have access to a national provider network?	No
Is a referral required to see a Specialist?	Not Covered
Does this plan cover services outside plan service area?	Yes - LifeWise Member have access to the LifeWise Primary network of provider when outside the Service Area. Our Service Area is Pierce, Snohomish and Spokane Counties in Washington. Benefits are not provided for out-of network providers
Does this plan cover services outside the country?	No - Emergency Services only

Hospital services
Emergency Room Services	$250 Copay with deductible, 30.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Inpatient Hospital Services (e.g., Hospital Stay)	30.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	30.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service	30.00% Coinsurance after deductible

Maternity
Prenatal and Postnatal Care	30.00% Coinsurance after deductible
Delivery and all inpatient services for maternity care	30.00% Coinsurance after deductible

Mental Health
Mental/Behavioral Health Outpatient Services	$60 Copay
Mental/Behavioral Health Inpatient Services	30.00% Coinsurance after deductible
Substance use disorder outpatient services	$60 Copay
Substance use disorder inpatient services	30.00% Coinsurance after deductible

Medical Management Programs
Does this plan offer disease managment programs?	Asthma, Diabetes, Heart Disease
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 Hearing Aids Imaging (CT/PET Scans, MRIs) Outpatient Surgery Physician/Surgical Services Urgent Care Centers or Facilities Inpatient Physician and Surgical Services Durable Medical Equipment Dental Anesthesia Diabetes Care Management Inherited Metabolic Disorder - PKU Abortion for Which Public Funding is Prohibited 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	Skilled Nursing Facility Acupuncture Long Term Care Home Health Care Services Outpatient Rehabilitation Services Habilitation Services Hospice Services Chiropractic Care Rehabilitative Occupational and Rehabilitative Physical Therapy Rehabilitative Speech Therapy Long-Term/Custodial Nursing Home Care
More Excluded Benefits	Bariatric Surgery Cosmetic Surgery Infertility Treatment Private-Duty Nursing Weight Loss Programs Dental Check-Up for Children Routine Foot Care Dental Care - Adult Accidental Dental Allergy Testing

+ See All Coverage Details

Premium	Plan Name	Deductible
from $348	Flex Silver HD - 21	$3,000.00	Select
from $370	Silver HSA - 21	$3,000.00	Select
from $404	KP WA Silver 3000/20% HSA with Pediatric Dental	$3,000.00	Select
from $413	Alliance Silver 3000 EPO Legacy LHP	$3,000.00	Select
from $432	Silver HDHP 3000 EPO Individual and Family Network	$3,000.00	Select

Last Name

Location/Distance

Please select the correct zip

Jonathan, Moceri

Sheryl, Morelli

David, Viscardi

Bethanie, Bayha

Ashley, Jerath Tatum

Howard, Roth

Joseph, Knight

Kandyce, Crandall

Danielle, Valdes

Gpc, Pllc

Lindsey, Tennant-moore

Mary, Barrett

Alicia, Myers

Helpprn Pllc

Erika, Clute

Ryan, Wilson

Laura, Sargent

Samantha, Vanderputten

Sametra, Green

Rachel, Smith

Sierra, Owsley

Margaret, Flack

Maegan, Bell

Jonathan Moceri, MD

Phone Number
(206) 954-5525
Office Locations
1037 Ne 65th St
Seattle, WA 98115

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.

ZIP Code
County
Applicant Info
Applicant
Date of birth
//
Gender
male
female
Income
$

Health Plans Found

Sort by

We do not have any data on plans available in your area. Please contact www.healthcare.gov.

HealthPocket.com provides information on insurance products. If you choose to obtain a quote or apply for an insurance plan, you may be transferred to a partner website to complete your request. Always review the privacy and terms of use of the partner website.

LifeWise Primary Silver

Apply For This Plan

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

Similar Plans

Physician Finder

Related Articles

Related Searches

Silver plan frequently asked questions (FAQ)

What Is the Silver Plan?

How are Silver Plans different than other Obamacare health plans?

How much does a Silver Plan cost?

When Can I Enroll in a Silver Plan?

Apply For This Plan

Health Plans Found