This plan offers a deductible and coinsurance midway between the Bronze and Gold HDHP plans. This is the perfect plan for you if you want a reasonable deductible at a lower premium than a gold level plan. Once your deductible has been met, you will be responsible for 20 percent coinsurance on additional in-network medical care you receive. In addition, you get a $0 annual vision exam and dental exam for each covered member. This plan is HSA (Health Savings Account) qualified if a cost-sharing reduction subsidy is not applied. The below chart details the benefits of this plan.
Prestige Silver 20 HDHP Plan Highlights |
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DEDUCTIBLE |
Individual |
$3,500 |
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Family |
$7,000 |
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COINSURANCE |
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20% |
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OUT-OF- |
Individual |
$7,050 |
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Family |
$14,100 |
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BENEFITS |
Preventive Care |
$0 |
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Routine Vision Exam |
$0 |
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Annual Dental Exam |
$0 |
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Personal Doctor Visit |
20% after deductible |
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Virtual Visit |
0% after deductible |
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Specialist Visit |
20% after deductible |
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Chiropractic |
20% after deductible |
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Hospital Stay |
20% after deductible |
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Emergency Room |
20% after deductible |
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X-ray and Diagnostic Imaging |
20% after deductible |
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All Network Health’s Prestige plans have built-in pharmacy benefits. See the chart below for prescription drug coverage information.
Prestige Silver 20 HDHP Pharmacy Benefit Highlights |
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Retail |
Preventive Drugs |
$0 |
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Tier 1 Adherence Generics (limited only to categories of select antidiabetics, statins and RAS antagonists) |
0% after deductible |
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Tier 2 Generics |
20% after deductible |
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Tier 3 Preferred Brand Drugs |
20% after deductible |
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Tier 4 Non-Preferred Brand Drugs |
50% after deductible |
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Tier 5 Preferred Specialty Drugs |
40% after deductible |
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Tier 6 Non-Preferred Specialty Drugs |
50% after deductible |
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