Silver 87 Access Care

Access Care plans offer you affordability and great freedom of choice with our widest network of providers, including 85% of Idaho’s doctors and hospitals.  If you qualify for a tax credit, your costs could be even lower. Have questions? Just call us at 855-447-2900.

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Download a 2019 PDF comparison chartDownload a 2018 PDF comparison chartDownload a 2017 PDF comparison chart

Silver 87 Access Care

In Network Out of Network
Deductible
(What’s This?)
Individual: $300
Family: $600
Individual: $15,000
Family: $30,000
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $2,250
Family: $4,500
Individual: $40,000
Family: $80,000
Co-insurance
(What’s this?)
You pay 30% You pay 50%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
You pay $35 copay per visit You pay 50% after deductible
Specialist Office Visit
You pay $40 copay per visit You pay 50% after deductible
Emergency Room Visits You pay 30% after deductible You pay 30% after deductible
Prescription Drugs
(View Drug List)
Tier 0: You pay $0
Tier 1 Generic: You pay $5 per drug
Tier 2 Preferred Brand: You pay 25% per drug
Tier 3 Non-preferred: You pay 40% per drug
Tier 4 Specialty: You pay 40% per drug
Tier 0: You pay $0
Tier 1 Generic: You pay 50% coinsurance per drug
Tier 2 Preferred Brand: You pay 50% coinsurance per drug
Tier 3 Non-preferred: You pay 50% coinsurance per drug
Tier 4 Specialty: You pay 50% coinsurance per drug
Preventive Care Services, Immunizations You pay nothing for preventive services in-network–deductible does not apply You pay 50% coinsurance per drug
Chiropractic Care
(Covered up to 20 visits per year)
You pay 30% after deductible You pay 50% coinsurance per drug
Diagnostic X-Ray & Lab Services You pay 30% after deductible You pay 50% coinsurance per drug
Inpatient Hospital Services You pay 30% after deductible You pay 50% coinsurance per drug
Maternity You pay 30% after deductible You pay 50% coinsurance per drug
Physician, Surgical & Medical Services You pay 30% after deductible You pay 50% coinsurance per drug
Outpatient Rehabilitation Services; Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 30% after deductible You pay 50% coinsurance per drug
Habilitative Services, Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 30% after deductible You pay 50% coinsurance per drug

Get Pricing Download a PDF comparison chart

Silver 87 Access Care

In Network Out of Network
Deductible
(What’s This?)
Individual: $300
Family: $600
Individual: $15,000
Family: $30,000
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $2,450
Family: $4,900
Individual: $25,000
Family: $50,000
Co-insurance
(What’s this?)
You pay 20% You pay 60%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
You pay $25 copay per visit You pay 60% after deductible
Specialist Office Visit
You pay $40 per visit You pay 60% after deductible
Emergency Room Visits You pay $350 per visit You pay $350 per visit
Prescription Drugs
(View Drug List)
Tier 0: You pay $0
Tier 1 Generic: You pay $5 per drug
Tier 2 Preferred Brand: You pay 25% per drug
Tier 3 Non-preferred: You pay 30% per drug
Tier 4 Specialty: You pay 40% per drug
Tier 0: You pay $0
Tier 1 Generic: You pay 60% coinsurance per drug
Tier 2 Preferred Brand: You pay 60% coinsurance per drug
Tier 3 Non-preferred: You pay 60% coinsurance per drug
Tier 4 Specialty: You pay 60% coinsurance per drug
Preventive Care Services, Immunizations You pay nothing for preventive services in-network–deductible does not apply You pay 60% coinsurance per drug
Chiropractic Care
(Covered up to 20 visits per year)
You pay 20% after deductible You pay 60% coinsurance per drug
Diagnostic X-Ray & Lab Services You pay 20% after deductible You pay 60% coinsurance per drug
Inpatient Hospital Services You pay 20% after deductible You pay 60% coinsurance per drug
Maternity You pay 20% after deductible You pay 60% coinsurance per drug
Physician, Surgical & Medical Services You pay 20% after deductible You pay 60% coinsurance per drug
Outpatient Rehabilitation Services; Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 20% after deductible You pay 60% coinsurance per drug
Habilitative Services, Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 20% after deductible You pay 60% coinsurance per drug

Get Pricing Download a PDF comparison chart