Effective February 1, 2023 - Hillcrest HealthCare System is in network for our group, individual and family plans!

Plan Details

CommunityCare PPO Silver B19 Standard

Plan Year:

Silver Metal plans cover an estimated 70% of your medical and prescription drug costs. They limit your annual out-of-pocket expenses.

Individual Deductible:$6,000
Individual Out of Pocket Maximum:$8,900
Office Visit Copay:$25
Out of Network Coinsurance:30%*
Preferred Generics:$15
Preferred Brand Name:$45
Non-Preferred Brand Name:50%
Individual Rx Deductible:None
Preferred Specialty:50%
Non-Preferred Specialty:50%
OON Individual Deductible:$12,000
OON Family Deductible:$36,000
OON OOP Individual Deductible:Unlimited
OON OOP Family Deductible:Unlimited
OON Office Visit Copay:30%*
Specialist Copay:$50
OON Specialist Copay:30%*
*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
Coronavirus Self-CheckerX