ATRIO Health Plans, Inc.*

ATRIO Health Plans, Inc.* | ATRIO Silver Pioneer

  • ATRIO Silver Pioneer is an Obamacare health insurance plan offered by ATRIO Health Plans, Inc.* that is available for individuals and families.

  • This plan is a EPO, meaning you will have some of the flexibility to manage more of your health care without a primary care physician, however, you will need to stay within the provider’s network. (Read more about EPOs.)

  • 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 Not Applicable. 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 Not Applicable, 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

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Plan Summary

Monthly Cost

Plan Name:
ATRIO Silver Pioneer

Plan ID:
32536OR0040002

Plan Type:
EPO

Deductible:
Not Applicable

Maximum Out-of-Pocket:
Not Applicable

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 low deductible on this plan means you won't have to pay as much money out 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 internet start-up for healthcare consumers. We’re not the government website.

Highlights


Emergency Room:
30% Coinsurance after deductible

Retail Drugs:
$50

Generic Drugs:
$15

Overview


Plan Type:
EPO

Metal Level:
Silver

Health Spending Account:
No

Primary Care Office Visit:
$35

Specialist Office Visit:
$70

Out of Network Coverage:
Yes

Out of Country Coverage:
Yes

Coverage Details

Preventive Care

Periodic Health Exam
In Network:
No Charge

Out of Network:
Not Covered
Well Baby Care
In Network:
No Charge

Out of Network:
Not Covered

Inpatient

Hospital Services
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
Physician Fee
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
Skilled Nursing Facility
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
Mental Health
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
Substance Abuse
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
Home Healthcare
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered

Outpatient

Surgery
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
X-ray and Diagnostics
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
Labs
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
Facility Fee
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
Mental Health
In Network:
$70

Out of Network:
Not Covered
Substance Abuse
In Network:
$70

Out of Network:
Not Covered
Rehabilitation Services
In Network:
$35

Out of Network:
Not Covered

Maternity/Pregnancy

Pre & Postnatal Care
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
Labor and Delivery Inpatient Services
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered

Dental

Accidental Care
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered

Vision

Eye Exam (Child)
In Network:
No Charge

Out of Network:
No Charge
Glasses (Child)
In Network:
No Charge

Out of Network:
No Charge

Additional Coverage

Habilitation Services
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
Rehabilitation Services (Speech)
In Network:
$35

Out of Network:
Not Covered
Rehabilitation Services (Occupational Therapy)
In Network:
$35

Out of Network:
Not Covered
Hospice Service
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
Diabetes Care Management
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
Durable Medical Equipment
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
Hearing Aids
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
Nutritional Consuleling
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
Cosmetic Surgery
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered
Reconstructive Surgery
In Network:
30% Coinsurance after deductible

Out of Network:
Not Covered

Doctor Visits

Primary Care Visit
In Network:
$35

Out of Network:
Not Covered
Specialist Visit
In Network:
$70

Out of Network:
Not Covered
Other Practitioner Office Visit
In Network:
$35

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

Out of Network:
Not Covered

Emergency Room and Urgent Care

Emergency Room Services
In Network:
30% Coinsurance after deductible

Out of Network:
30% Coinsurance after deductible
Urgent Care Services
In Network:
$90

Out of Network:
$90
Ambulance/Transportation Services
In Network:
30% Coinsurance after deductible

Out of Network:
30% Coinsurance after deductible

Drugs

Generic Prescription
In Network:
$15

Out of Network:
$15
Retail Brand Drugs
In Network:
$50

Out of Network:
$50
Non Retail Brand Drugs
In Network:
50%

Out of Network:
50%
Specialty Drugs
In Network:
50%

Out of Network:
50%
Drug Deductible
In Network:
Individual: Not Applicable Family: Not Applicable

Out of Network:
Individual: Not Applicable Family: Not Applicable

Additional Plan Information

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.

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