Plan Brochure
CommunityCare Silver SLIH23
Plan Year:
2023
Metal Level:
Silver
Silver Metal plans cover an estimated 70% of your medical and prescription drug costs. They limit your annual out-of-pocket expenses.
| Individual Deductible: | $6,600 |
| Individual Out of Pocket Maximum: | $8,900 |
| Office Visit Copay: | $35 |
| Preferred Generics: | $10 |
| Preferred Brand Name: | $55 |
| Non-Preferred Brand Name: | 40%* |
| Individual Rx Deductible: | Integrated |
| Preferred Specialty: | 50%* |
| Non-Preferred Specialty: | 50%* |
First 3 telehealth visits at $0.
*Subject to the deductible.
Essential Benefits
All health plans in the exchanges are required to provide a minimum set of benefits which are termed essential benefits. These benefits include:
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health services
- Substance use disorder services
- Prescription drug coverage
- Rehabilitative and habilitative services and devices
- Preventative and wellness services
- Pediatric Services
