Market HMO 4000 HSA – NE Ohio
Plan Type: | HMO |
Plan Tier: | Silver |
Medical Deductible - Individual: | $4,000 |
Medical Deductible - Family: | $8,000 |
Drug Deductible - Individual: | Included in Medical |
Drug Deductible - Family: | Included in Medical |
Out of Pocket Max - Individual: | $4,000 |
Out of Pocket Max - Family: | $8,000 |
Primary Care Visit: | No Charge after Deductible |
Specialist Visit: | No Charge after Deductible |
Emergency Room: | No Charge after Deductible |
Hospital - Physician: | No Charge after Deductible |
Hospital - Facility: | No Charge after Deductible |
Link to Full SBC: | https://mybrokerlink.com/GetSbc?mmi=005006010000000000 |
Plan Brochure: |
Other Coverage:
Child Dental: | No |
Adult Dental | No |
Prescription Drug Pricing:
Generic Drugs: | No Charge after Deductible |
Non-Preferred Brand Drugs: | No Charge after Deductible |
Preferred Brand Drugs: | No Charge after Deductible |
Specialty Drugs: | No Charge after Deductible |
Link to Full Policy Formulary: | https://www.medmutual.com/~/media/46857AF483D94EA49ADA66A2EAE7A784.ashx |
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