Great coverage & lower out-of-pocket costs
Based on their income, some individuals and families may qualify for an Enhanced Silver Plan. These plans offer Gold or Platinum level benefits , plus out-of-pocket savings through lower copays, co-insurance, and deductibles.
To find out if you qualify for an Enhanced Silver Plan or for free help choosing the right plan, see if I qualify.
Enhanced Silver Benefit Plans
ENHANCED SILVER 94
ENHANCED SILVER 87
ENHANCED SILVER 73
SILVER
May be eligible for premium assistance
Key Benefits
Benefits in Blue are subject to deductibles
Copays in Black are not subject to any deductible and count toward the annual out-of-pocket maximum.
Individual Deductible
No Deductible
$500 medical deductible
$50 brand drug
deductible
$1600 medical deductible
$250 brand drug
deductible
$2000 medical deductible
$250 brand drug
deductible
Family Deductible
No Deductible
$1000 medical deductible
$100 brand drug
deductible
$3200 medical deductible
$500 brand drug
deductible
$4000 medical deductible
$500 brand drug
deductible
Preventative Care Copay1
(Deductible does not apply)
No Cost
No Cost
No Cost
No Cost
Primary Care Visit Copay
$3
$15
$40
$45
Specialty Care Visit Copay
$5
$20
$50
$65
Urgent Care Visit Copay
$6
$30
$80
$90
Generic Medication Copay
$3
$5
$15
$15
Lab Testing Copay
$3
$15
$40
$45
X-Ray Copay
$5
$20
$50
$65
Emergency Room Copay
$25
$75
$250
$250
High Cost and Infrequent Services (e.g. Hospital Stay)
10%
15%
20% of your plan's negotiated rate
20% of your plan's negotiated rate
Preferred Brand Copay After Drug Deductible (if any)
$5
$15
$35
$50
Maximum Out-of-Pocket for Individuals
$2,250
$2,250
$5,200
$6,250
Maximum Out-of-Pocket for Families
$4,500
$4,500
$10,400
$12,500
1 In-network Only
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