Silver Option 2 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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Silver Option 2 Access Care

In Network Out of Network
Deductible
(What’s This?)
Individual: $4,500
Family: $9,000
Individual: $25,000
Family: $50,000
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $7,450
Family: $14,900
Individual: $50,000
Family: $100,000
Co-insurance
(What’s this?)
You pay 40% You pay 60%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
You pay $60 copay per visit You pay 60% coinsurance after deductible
Specialist Office Visit
You pay $80 copay per visit after deductible You pay 60% coinsurance after deductible
Emergency Room Visits You pay 40% after deductible You pay 40% after deductible
Prescription Drugs
(View Drug List)
Tier 0: You pay $0
Tier 1 Generic: You pay $10 per drug
Tier 2 Preferred Brand: You pay 30% coinsurance after deductible per drug
Tier 3 Non-preferred: You pay 50% coinsurance after deductible per drug
Tier 4 Specialty: You pay 50% coinsurance after deductible per drug
Tier 0: You pay $0
Tier 1 Generic: You pay 60% coinsurance after deductible
Tier 2 Preferred Brand: You pay 60% coinsurance after deductible
Tier 3 Non-preferred: You pay 60% coinsurance after deductible
Tier 4 Specialty: You pay 60% coinsurance after deductible
Preventive Care Services, Immunizations You pay nothing for preventive services in-network–deductible does not apply You pay 60% coinsurance after deductible
Chiropractic Care
(Covered up to 20 visits per year)
You pay 40% coinsurance after deductible You pay 60% coinsurance after deductible
Diagnostic X-Ray & Lab Services You pay 40% coinsurance after deductible You pay 60% coinsurance after deductible
Inpatient Hospital Services You pay 40% coinsurance after deductible You pay 60% coinsurance after deductible
Maternity You pay 40% coinsurance after deductible You pay 60% coinsurance after deductible
Physician, Surgical & Medical Services You pay 40% coinsurance after deductible You pay 60% coinsurance after deductible
Outpatient Rehabilitation Services; Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 40% coinsurance after deductible You pay 60% coinsurance after deductible
Habilitative Services, Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 40% coinsurance after deductible You pay 60% coinsurance after deductible

Get Pricing Download a PDF comparison chart

Silver Option 2 Access Care

In Network Out of Network
Deductible
(What’s This?)
Individual: $5,200
Family: $10,400
Individual: $30,000
Family: $60,000
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $7,350
Family: $14,700
Individual: $50,000
Family: $100,000
Co-insurance
(What’s this?)
You pay 40% You pay 60%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
You pay $30 copay per visit You pay 60% coinsurance after deductible
Specialist Office Visit
You pay $75 copay per visit after deductible You pay 60% coinsurance after deductible
Emergency Room Visits You pay $450 copay per visit You pay $450 copay per visit
Prescription Drugs
(View Drug List)
Tier 0: You pay $0
Tier 1 Generic: You pay $10 per drug
Tier 2 Preferred Brand: You pay 30% coinsurance after deductible per drug
Tier 3 Non-preferred: You pay 40% coinsurance after deductible per drug
Tier 4 Specialty: You pay 50% coinsurance after deductible per drug
Tier 0: You pay $0
Tier 1 Generic: You pay 60% coinsurance after deductible
Tier 2 Preferred Brand: You pay 60% coinsurance after deductible
Tier 3 Non-preferred: You pay 60% coinsurance after deductible
Tier 4 Specialty: You pay 60% coinsurance after deductible
Preventive Care Services, Immunizations You pay nothing for preventive services in-network–deductible does not apply You pay 60% coinsurance after deductible
Chiropractic Care
(Covered up to 20 visits per year)
You pay 40% coinsurance after deductible You pay 60% coinsurance after deductible
Diagnostic X-Ray & Lab Services You pay 40% coinsurance after deductible You pay 60% coinsurance after deductible
Inpatient Hospital Services You pay 40% coinsurance after deductible You pay 60% coinsurance after deductible
Maternity You pay 40% coinsurance after deductible You pay 60% coinsurance after deductible
Physician, Surgical & Medical Services You pay 40% coinsurance after deductible You pay 60% coinsurance after deductible
Outpatient Rehabilitation Services; Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 40% coinsurance after deductible You pay 60% coinsurance after deductible
Habilitative Services, Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 40% coinsurance after deductible You pay 60% coinsurance after deductible

Get Pricing Download a PDF comparison chart