Oscar Silver HDHP Plan Details for 2021- HealthPocket

Insurance Type	ACA (Obamacare)
Plan Name	Oscar Silver HDHP
Plan ID	hhs-13877AZ0070018
Plan Year	2021
Insurance Provider	Oscar Health Plan, Inc.
Metal Level	Silver
Plan Type	HMO
Deductible	$3,000
Out-of-Pocket Maximum	$7,000
Plan Highlights

Costs for Medical Care
Primary Care Visit to Treat an Injury or Illness	$30 Copay after deductible
Specialist Visit	$75 Copay after deductible
Laboratory Outpatient and Professional Services	$50 Copay after deductible
X-rays and Diagnostic Imaging	$75 Copay after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans	$100 Copay after deductible
Deductible - Family	$6000 per group
Out-of-Pocket Maximum - Family	$14000 per group

Prescription drug coverage
Generic Drugs	$3 Copay after deductible
Preferred Brand Drugs	$100 Copay after deductible
Non-Preferred Brand Drugs	40.00% Coinsurance after deductible
Specialty Drugs	40.00% Coinsurance after deductible

Access to doctors and hospitals
Provider directory URL	https://www.hioscar.com/search
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 - Emergency and Urgent Services only.
Does this plan cover services outside the country?	Yes - Emergency Services only.

Hospital services
Emergency Room Services	40.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	40.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	40.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service	40.00% Coinsurance after deductible

Maternity
Prenatal and Postnatal Care	Not Applicable
Delivery and all inpatient services for maternity care	40.00% Coinsurance after deductible

Mental Health
Mental/Behavioral Health Outpatient Services	$30 Copay after deductible
Mental/Behavioral Health Inpatient Services	40.00% Coinsurance after deductible
Substance use disorder outpatient services	$30 Copay after deductible
Substance use disorder inpatient services	40.00% Coinsurance after deductible

Medical Management Programs
Does this plan offer disease managment programs?	Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs
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	Included
Child Dental Coverage - Basic Dental Care	Included
Child Dental Coverage - Orthodontia	Included
Child Dental Coverage - Major Dental Care	Included

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) Bariatric Surgery Private-Duty Nursing Imaging (CT/PET Scans, MRIs) Outpatient Surgery Physician/Surgical Services Urgent Care Centers or Facilities Inpatient Physician and Surgical Services Habilitation Services Durable Medical Equipment Hospice Services Dental Check-Up for Children 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	Preventive Care/Screening/Immunization Skilled Nursing Facility Hearing Aids Home Health Care Services Outpatient Rehabilitation Services Chiropractic Care Rehabilitative Occupational and Rehabilitative Physical Therapy Rehabilitative Speech Therapy
More Excluded Benefits	Acupuncture Cosmetic Surgery Infertility Treatment Weight Loss Programs Routine Foot Care Abortion for Which Public Funding is Prohibited Long-Term/Custodial Nursing Home Care

+ See All Coverage Details

Premium	Plan Name	Deductible
from $338	Ambetter Balanced Care 209 (2021)	$2,995.00	Select
from $395	Ambetter Balanced Care 209 (2021) + Vision + Adult Dental	$2,995.00	Select
from $464	Ambetter Secure Care 201 HSA (2021)	$3,200.00	Select
from $486	Ambetter Secure Care 201 HSA (2021) + Vision + Adult Dental	$3,200.00	Select

Last Name

Location/Distance

Please select the correct zip

Rajesh, Khona

Kita, Patel

William, Shea

Timothy, Graham

Jay, Eldridge

Donald, Runyan

Shawn, Hermenau

Sw Rehab

Nicolas, Santos

Nnabuikem, Anaba

Kailey, Rote

Joseph, Sanchez

Michael, Mccullagh

Zachary, Parkinson

Shanti Anesthesiology, Pllc

Nafisah, Naqvi

Stephanie, Clark

Mina, Tawadrous

Lee, Barnwell

Marjorie, Bacon

Jennifer, Mccumbee

James, Lavin

Kemell Health Llc

Southwestern Palliative Care Associates Plc

View All Details

Rajesh Khona, M.D.

View All Details

Phone Number
(602) 273-6770
Office Locations
2400 S Avenue A
Yuma, AZ 85364

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.

Zip Code	85364 (edit)
Applicant	1/22/1986 Male (edit)

Zip Code	85364 (edit)
Applicant	1/22/1986 Male (edit)

Oscar Silver HDHP

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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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