EOBs for plan members are temporarily unavailable to view online. If you have questions about plan benefits, please contact the CommunityCare customer service team for assistance.

Plan Details

CommunityCare Silver 10 Standard

98905OK0180040-00
Plan Year:
2017
Individual Deductible:$5,500
Individual Out of Pocket Maximum:$6,800
Office Visit Copay:$25
Preferred Generics:$15
Preferred Brand Name:$40*
Non-Preferred Brand Name:$70*
Specialty:$160*
*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