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Medica Insure Silver Copay
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Medica Insure Silver Copay

Overview
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Medica Insure Silver Copay is an individual health health plan issued by Medica Insurance Company and is available for the year 2019. This health plan is offered by the federal government through HealthCare.gov and the Affordable Care Act (ACA).

Where Do I Need to Live to Quality for this Plan?

This plan is available for qualifying individuals who live in Kearney county, Nebraska.

What Type of Health Plan Is This?

This plan is an EPO plan, which is also known as an "Exclusive Provider Organization." An EPO is a managed care plan where services are covered so long as the the hospitals, dentists, and other health providers in the plan's network are used.

Where Can I Buy This Plan?

You can purchase this plan at HealthCare.gov.

About
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Issuer
Medica Insurance Company
Plan ID
20305NE0040003
Coverage area
Kearney County, Nebraska
Phone
Local Phone: 1-888-592-8211
Toll-Free: 1-888-592-8211
TTY: 1-800-833-7352
Plan type
EPO
Coverage type
Medical deductible
$3,700
Out-of-pocket maximum
$7,600
Generic drug co-pay
$20
Preferred brand drug co-pay
$120
Primary care physician visit cost
$30
Specialist doctor visit cost
$60
Doctor Visits
Primary Care Visit $30
Specialist Visit $60
Emergency Room Visit 40% Coinsurance after deductible
Inpatient Facility Visit 40% Coinsurance after deductible
Inpatient Physician Visit 40% Coinsurance after deductible
Prescription Drugs
Generic Drugs $20
Preferred Brand Drugs $120
Non-preferred Brand Drugs 60% Coinsurance after deductible
Specialty Drugs $550
Medical Deductible
Medical Deductible (Individual) $3,700
Medical Maximum Out Of Pocket (Individual) $7,600
Medical Deductible (Family) $11,100
Medical Maximum Out Of Pocket (Family) $15,200
Drug Deductible
Drug Deductible (Individual) Included in Medical
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) Included in Medical
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 100.00%
Premium Child Age 0-14 529
Premium Child Age 18 631
Premium Adult Individual Age 21 692
Premium Adult Individual Age 27 725
Premium Adult Individual Age 30 785
Premium Adult Individual Age 40 884
Premium Adult Individual Age 50 1,235
Premium Adult Individual Age 60 1,878
Premium Couple 21 1,384
Premium Couple 30 1,570
Premium Couple 40 1,768
Premium Couple 50 2,471
Premium Couple 60 3,756
Couple+1 child, Age 21 1,913
Couple+1 child, Age 30 2,100
Couple+1 child, Age 40 2,298
Couple+1 child, Age 50 3,001
Couple+2 children, Age 21 2,442
Couple+2 children, Age 30 2,629
Couple+2 children, Age 40 2,827
Couple+2 children, Age 50 3,530
Couple+3 or more Children, Age 21 2,972
Couple+3 or more Children, Age 30 3,158
Couple+3 or more Children, Age 40 3,356
Couple+3 or more Children, Age 50 4,059
Individual+1 child, Age 21 1,221
Individual+1 child, Age 30 1,314
Individual+1 child, Age 40 1,413
Individual+1 child, Age 50 1,765
Individual+2 children, Age 21 1,750
Individual+2 children, Age 30 1,844
Individual+2 children, Age 40 1,943
Individual+2 children, Age 50 2,294
Individual+3 or more children, Age 21 2,280
Individual+3 or more children, Age 30 2,373
Individual+3 or more children, Age 40 2,472
Individual+3 or more children, Age 50 2,824
Reference
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  • HealthCare.gov. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov
  • The 'metal' categories: Bronze, Silver, Gold & Platinum. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plans-categories
  • Health insurance plan & network types: HMOs, PPOs, and more. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plan-types