- State:
- Metal Level:
- Plan Type:
- Primary Care Visit: $35
- Generic Drugs: $35
- Medical Deductible (Individual): $6,650
- Medical Maximum Out Of Pocket (Individual): $7,900
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).
This plan is available for qualifying individuals who live in Nuckolls county, Nebraska.
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.
You can purchase this plan at HealthCare.gov.
| 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 |
| Generic Drugs | $20 |
|---|---|
| Preferred Brand Drugs | $120 |
| Non-preferred Brand Drugs | 60% Coinsurance after deductible |
| Specialty Drugs | $550 |
| 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 (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 |
| 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 |
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