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

Plan Details

CommunityCare PPO Silver H23 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:$7,700
Individual Out of Pocket Maximum:$8,700
Office Visit Copay:$35
Out of Network Coinsurance:70%*
Preferred Generics:$15
Preferred Brand Name:$45*
Non-Preferred Brand Name:$95*
Individual Rx Deductible:$500
Preferred Specialty:$300*
Non-Preferred Specialty:$350*
OON Individual Deductible:$17,400
OON Family Deductible:$35,800
OON OOP Individual Deductible:Unlimited
OON OOP Family Deductible:Unlimited
OON Office Visit Copay:70%*
Specialist Copay:$65
OON Specialist Copay:70%*
*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
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