Altius

Altius | Altius Silver $15 Copay PD

  • Altius Silver $15 Copay PD is an Obamacare health insurance plan offered by Altius that is available for individuals and families.

  • This plan is a POS, meaning you will require a primary care physician to manage your care like in an HMO, but you will have more flexibility than in an HMO to go out-of-network. (Learn more about POS plans.)

  • This plan is a Silver metal level plan, which generally has a mid-level monthly cost and deductible (and co-pay), and provides middle-of-the-road insurance coverage for people who occasionally use their health care benefits (doctors, prescription drugs, etc.).

  • Deductible amount of $3,500. A deductible is the amount of healthcare costs you will pay on your own each year before the insurance company.

  • Max out-of-pocket of , which is the most you will pay in a plan year outside of premiums, out-of-network providers and non-essential health benefits.


Ways to Enroll or Learn More

SPEAK WITH A LICENSED AGENT

Plan Summary

Monthly Cost

Plan Name:
Altius Silver $15 Copay PD

Plan ID:
38927UT0350006

Plan Type:
POS

Deductible:
$3,500

Maximum Out-of-Pocket:

Summary of Benefits:

Provider Information:

Who is this plan for?

This plan with a moderate monthly cost is great for individuals and families who occasionally visit the doctor or use prescription drugs. The very high deductible on this plan means you will pay a significant amount of money of pocket for medical care and prescriptions before your insurance kicks in. The low out-of-pocket maximum on this plan protects you from having to pay a large medical bill if an emergency happens.

HealthCare.com is a privately-held website for healthcare consumers operating since 2007. We’re not the government marketplace.

Highlights


Emergency Room:
30% coinsurance

Retail Drugs:
$55 copay

Generic Drugs:
$20 copay

Overview


Plan Type:
POS

Metal Level:
Silver

Health Spending Account:

Primary Care Office Visit:
$15 copay/visit

Specialist Office Visit:
$75 copay/visit

Out of Network Coverage:
No

Out of Country Coverage:
No

Coverage Details

Preventive Care

Periodic Health Exam
In Network:
No Charge

Out of Network:
50% coinsurance

Inpatient

Hospital Services
In Network:
$500 copay/admit + 30% coinsurance

Out of Network:
50% coinsurance
Physician Fee
In Network:
30% coinsurance

Out of Network:
50% coinsurance
Skilled Nursing Facility
In Network:
30% coinsurance

Out of Network:
50% coinsurance
Mental Health
In Network:
$500 copay/admit + 30% coinsurance

Out of Network:
50% coinsurance
Substance Abuse
In Network:
$500 copay/admit + 30% coinsurance

Out of Network:
50% coinsurance
Home Healthcare
In Network:
30% coinsurance

Out of Network:
50% coinsurance

Outpatient

Surgery
In Network:
30% coinsurance

Out of Network:
50% coinsurance
X-ray and Diagnostics
In Network:
30% coinsurance

Out of Network:
50% coinsurance
Labs
In Network:
30% coinsurance

Out of Network:
50% coinsurance
Facility Fee
In Network:
$250 copay/service + 30% coinsurance

Out of Network:
50% coinsurance
Mental Health
In Network:
$75 copay/visit

Out of Network:
50% coinsurance
Substance Abuse
In Network:
$75 copay/visit

Out of Network:
50% coinsurance
Rehabilitation Services
In Network:
30% coinsurance

Out of Network:
50% coinsurance

Maternity/Pregnancy

Pre & Postnatal Care
In Network:
Prenatal: No Charge, Postnatal and Delivery: 30% co-insurance

Out of Network:
50% coinsurance
Labor and Delivery Inpatient Services
In Network:
$500 copay/admit + 30% coinsurance

Out of Network:
50% coinsurance

Dental

Dental Checkup (Child)
In Network:
No Charge

Out of Network:
30% coinsurance

Vision

Eye Exam (Child)
In Network:
No Charge

Out of Network:
50% coinsurance
Glasses (Child)
In Network:
No Charge

Out of Network:
50% coinsurance

Additional Coverage

Chiropractic Care
In Network:
Not Covered

Out of Network:
Not Covered
Habilitation Services
In Network:
30% coinsurance

Out of Network:
50% coinsurance
Hospice Service
In Network:
30% coinsurance

Out of Network:
50% coinsurance
Durable Medical Equipment
In Network:
50% coinsurance

Out of Network:
50% coinsurance

Doctor Visits

Primary Care Visit
In Network:
$15 copay/visit

Out of Network:
50% coinsurance
Specialist Visit
In Network:
$75 copay/visit

Out of Network:
50% coinsurance
Other Practitioner Office Visit
In Network:
Not Covered

Out of Network:
Not Covered
Preventative Care / Screening / Immunization
In Network:
No Charge

Out of Network:
50% coinsurance

Emergency Room and Urgent Care

Emergency Room Services
In Network:
30% coinsurance

Out of Network:
30% coinsurance
Urgent Care Services
In Network:
$75 copay/visit

Out of Network:
50% coinsurance
Ambulance/Transportation Services
In Network:
30% coinsurance

Out of Network:
30% coinsurance

Drugs

Generic Prescription
In Network:
$20 copay

Out of Network:
Not Covered
Retail Brand Drugs
In Network:
$55 copay

Out of Network:
Not Covered
Non Retail Brand Drugs
In Network:
$90 copay

Out of Network:
Not Covered
Specialty Drugs
In Network:
50% coinsurance

Out of Network:
Not Covered
Drug Deductible
In Network:
Individual: $500 Family: $1,000

Out of Network:
Individual: $1,000 Family: $2,000

Additional Plan Information

Summary Of Benefits:

Provider Information:

HealthCare.com is a privately owned website, and monthly costs shown above are estimates only. Your monthly premium may change based on the data provided, outside fees, optional benefits or if other factors take effect before your coverage start date. Note that insurance companies reserve the right to change your premium rate and the policy terms at any time. Effective date, benefit amounts and other conditions may apply at the discretion of the insurance carrier you select. Depending on your state of residence, this website may not display all plans available by state. The Obamacare Tax Subsidy Calculator amounts are estimates only and the actual amount of subsidy eligibility may differ. Access to your physician depends on network selected, and networks can change without notice. Contact your health insurance company to confirm your healthcare provider is still available in the network you select.

Coventry This site is not the Health Insurance Marketplace website, and the link to the FFM website is www.healthcare.gov.

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