Benefits & Coverage
Costs for Medical Care
Prescription drug coverage
Access to doctors and hospitals
Medical Management Programs
Child Dental Coverage
Adult Dental Coverage
Exclusions and Limitations
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
Durable Medical Equipment
Diabetes Care Management
Inherited Metabolic Disorder - PKU
Laboratory Outpatient and Professional Services
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Accidental Ingestion of a Controlled Drug
Bone Marrow Testing
Developmental Needs of Children & Youth with Cancer
Early Intervention Services
Network Retail Pharmacy (60-90 Day Supply) Covered
Off Label Prescription Drugs
Prescription Drugs Other
Rehabilitative Occupational Therapy
Treatment of Medical Complications of Alcoholism
Wound Care for Individuals with Epidermolysis Bullosa
Home Health Care Services
Outpatient Rehabilitation Services
Dental Check-Up for Children
Abortion for Which Public Funding is Prohibited
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
Long-Term/Custodial Nursing Home Care
Weight Loss Programs
Routine Foot Care
What To Know
- This is an ACA (Obamacare) compliant health plan.
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Types of Health Insurance
Health Insurance in 2018
Silver plan frequently asked questions (FAQ)
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.