Coventry Missouri KS

Coventry Missouri KS | Coventry Silver $10 Copay

  • Coventry Silver $10 Copay is an Obamacare health insurance plan offered by Coventry Missouri KS that is available for individuals and families.

  • This plan is a PPO, meaning you will have the flexibility to visit a preferred healthcare provider network that have preferred rates for in-network physicians. (Read more about PPOs.)

  • 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 $3,750. 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 $6,250, 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:
Coventry Silver $10 Copay

Plan ID:
44240MO0090002

Plan Type:
PPO

Deductible:
$3,750

Maximum Out-of-Pocket:
$6,250

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 very high out-of-pocket maximum on this plan means you could be faced with a very expensive medical bill if an emergency happens. Plans with this type of provider network tend to have a more broad provider network.

HealthCare.com is a privately-held internet start-up for healthcare consumers. We’re not the government website.

Highlights


Emergency Room:
$500 Copay after deductible

Retail Drugs:
$40Copay after deductible

Generic Drugs:
$15

Overview


Plan Type:
PPO

Metal Level:
Silver

Health Spending Account:
No

Primary Care Office Visit:
$10

Specialist Office Visit:
$75

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 after deductible
Well Baby Care
In Network:
No Charge

Out of Network:
50% Coinsurance after deductible

Inpatient

Hospital Services
In Network:
$500 Copay per Stay then 30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible
Physician Fee
In Network:
30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible
Skilled Nursing Facility
In Network:
30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible
Mental Health
In Network:
$500 Copay per Stay then 30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible
Substance Abuse
In Network:
$500 Copay per Stay then 30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible
Home Healthcare
In Network:
30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible

Outpatient

Surgery
In Network:
30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible
X-ray and Diagnostics
In Network:
30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible
Labs
In Network:
30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible
Facility Fee
In Network:
$250 then 30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible
Mental Health
In Network:
$75

Out of Network:
50% Coinsurance after deductible
Substance Abuse
In Network:
$75

Out of Network:
50% Coinsurance after deductible
Rehabilitation Services
In Network:
30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible

Maternity/Pregnancy

Pre & Postnatal Care
In Network:
$250

Out of Network:
50% Coinsurance after deductible
Infertility Treatment
In Network:
Not Covered

Out of Network:
Not Covered
Labor and Delivery Inpatient Services
In Network:
$500 then 30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible

Dental

Accidental Care
In Network:
$75

Out of Network:
50% Coinsurance after deductible

Vision

Eye Exam (Child)
In Network:
No Charge

Out of Network:
50% Coinsurance after deductible
Glasses (Child)
In Network:
No Charge

Out of Network:
50% Coinsurance after deductible

Additional Coverage

Chiropractic Care
In Network:
30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible
Habilitation Services
In Network:
30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible
Rehabilitation Services (Speech)
In Network:
30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible
Rehabilitation Services (Occupational Therapy)
In Network:
30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible
Hospice Service
In Network:
30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible
Diabetes Care Management
In Network:
$75

Out of Network:
50% Coinsurance after deductible
Durable Medical Equipment
In Network:
$75

Out of Network:
50% Coinsurance after deductible
Hearing Aids
In Network:
50% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible
Nutritional Consuleling
In Network:
No Charge

Out of Network:
50% Coinsurance after deductible
Reconstructive Surgery
In Network:
$250 then 30% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible

Doctor Visits

Primary Care Visit
In Network:
$10

Out of Network:
50% Coinsurance after deductible
Specialist Visit
In Network:
$75

Out of Network:
50% Coinsurance after deductible
Other Practitioner Office Visit
In Network:
$10

Out of Network:
50% Coinsurance after deductible
Preventative Care / Screening / Immunization
In Network:
No Charge

Out of Network:
50% Coinsurance after deductible

Emergency Room and Urgent Care

Emergency Room Services
In Network:
$500 Copay after deductible

Out of Network:
$500 Copay after deductible
Urgent Care Services
In Network:
$75

Out of Network:
50% Coinsurance after deductible
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:
$20
Retail Brand Drugs
In Network:
$40Copay after deductible

Out of Network:
$50 Copay after deductible
Non Retail Brand Drugs
In Network:
$80 Copay after deductible

Out of Network:
$90 Copay after deductible
Specialty Drugs
In Network:
50% Coinsurance after deductible

Out of Network:
50% Coinsurance after deductible
Drug Deductible
In Network:
Individual: $500 Family: Not Applicable

Out of Network:
Individual: $1,000 Family: Not Applicable

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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