Paramount Gold 3
| Plan Type: | HMO |
| Plan Tier: | Gold |
| Medical Deductible - Individual: | $2,000 |
| Medical Deductible - Family: | $4,000 |
| Drug Deductible - Individual: | $0 |
| Drug Deductible - Family: | $0 |
| Out of Pocket Max - Individual: | $5,000 |
| Out of Pocket Max - Family: | $10,000 |
| Primary Care Visit: | $15 |
| Specialist Visit: | $35 |
| Emergency Room: | 20% Coinsurance after deductible |
| Hospital - Physician: | 20% Coinsurance after deductible |
| Hospital - Facility: | 20% Coinsurance after deductible |
| Link to Full SBC: | http://www.paramounthealthcare.com/documents/marketplace/SBC2018-Gold3.pdf |
| Plan Brochure: | http://www.paramounthealthcare.com/documents/Marketplace/MarketplaceBrochure_2018.pdf |
Other Coverage:
| Child Dental: | No |
| Adult Dental | No |
Prescription Drug Pricing:
| Generic Drugs: | $15 |
| Non-Preferred Brand Drugs: | $75 |
| Preferred Brand Drugs: | $35 |
| Specialty Drugs: | 20% |
| Link to Full Policy Formulary: | http://www.paramounthealthcare.com/documents/marketplace/2018-Marketplace-Formulary.pdf |
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