Plan Brochure

CommunityCare Silver L 21 Select Plus

Plan Year:
2021
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:$7,700
Individual Out of Pocket Maximum:$8,100
Office Visit Copay:$35
Preferred Generics:$15
Preferred Brand Name:$45*
Non-Preferred Brand Name:$95*
Individual Rx Deductible:500
Preferred Specialty:$300*
Non-Preferred Specialty:$350*
*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