Silver 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 Access Care

In Network Out of Network
Deductible
(What’s This?)
Individual: $2,450
Family: $4,900
Individual: $30,000
Family: $60,000
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $7,250
Family: $14,500
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% after deductible
Specialist Office Visit
You pay $50 per visit You pay 60% after deductible
Emergency Room Visits You pay $450 per visit You pay $450 per visit
Prescription Drugs
(View Drug List)
Tier 0: You pay $0
Tier 1 Generic: You pay $10 per visit
Tier 2 Preferred Brand: You pay 30% per drug after deductible
Tier 3 Non-preferred: You pay 40% per drug after deductible
Tier 4 Specialty: You pay 50% per drug after deductible
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% after deductible You pay 60% coinsurance after deductible
Diagnostic X-Ray & Lab Services You pay 40% after deductible You pay 60% coinsurance after deductible
Inpatient Hospital Services You pay 40% after deductible You pay 60% coinsurance after deductible
Maternity You pay 40% after deductible You pay 60% coinsurance after deductible
Physician, Surgical & Medical Services You pay 40% 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% 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% after deductible You pay 60% coinsurance after deductible

Silver Access Care

Deductible
(What’s This?)
In Network Individual: $2,450
Family: $4,900
Out of Network Individual: $30,000
Family: $60,000
Annual Out-of-Pocket Maximum
(What’s this?)
In Network Individual: $7,250
Family: $14,500
Out of Network Individual: $50,000
Family: $100,000
Co-insurance
(What’s this?)
In Network You pay 40%
Out of Network You pay 60%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
In Network You pay $30 copay per visit
Out of Network You pay 60% after deductible
Specialist Office Visits
In Network You pay $50 per visit
Out of Network You pay 60% after deductible
Emergency Room Visits
In Network You pay $450 per visit
Out of Network You pay $450 per visit
Prescription Drugs
(View Drug List)
In Network Tier 0: You pay $0
Tier 1 Generic: You pay $10 per drug
Tier 2 Preferred Brand: You pay 30% per drug after deductible
Tier 3 Non-preferred: You pay 40% per drug after deductible
Tier 4 Specialty: You pay 50% per drug after deductible
Out of Network 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
In Network You pay nothing for preventive services in-network–deductible does not apply
Out of Network You pay 60% coinsurance after deductible
Chiropractic Care
(Covered up to 20 visits per year)
In Network You pay 40% after deductible
Out of Network You pay 60% coinsurance after deductible
Diagnostic X-Ray & Lab Services
In Network You pay 40% after deductible
Out of Network You pay 60% coinsurance after deductible
Inpatient Hospital Services
In Network You pay 40% after deductible
Out of Network You pay 60% coinsurance after deductible
Maternity
In Network You pay 40% after deductible
Out of Network You pay 60% coinsurance after deductible
Physician, Surgical & Medical Services
In Network You pay 40% after deductible
Out of Network You pay 60% coinsurance after deductible
Outpatient Rehabilitation Services; Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
In Network You pay 40% after deductible
Out of Network You pay 60% coinsurance after deductible
Habilitative Services, Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
In Network You pay 40% after deductible
Out of Network You pay 60% coinsurance after deductible

Get Pricing Download a PDF comparison chart

Silver Access Care

In Network Out of Network
Deductible
(What’s This?)
$2,250 individual,
$4,500 family
$6,750 individual,
$13,500 family
Annual Out-of-Pocket Maximum
(What’s this?)
$6,850 individual,
$13,700 family
$20,550 individual,
$41,100 family
Co-insurance
(What’s this?)
You pay 40% You pay 60%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
$35 copay after deductible You pay 60% after deductible
Special Office Visits You pay 40% after deductible You pay 60% 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 25% per drug
Tier 2 Preferred Brand: You pay 30% per drug
Tier 3 Non-preferred: You pay 50% per drug
Tier 4 Specialty: You pay 50% per drug
Tier 5 Non-preferred Specialty: You pay 50% per drug
Tier 0: You pay $0
Tier 1 Generic: You pay 25% per drug
Tier 2 Preferred Brand: You pay 30% per drug
Tier 3 Non-preferred: You pay 50% per drug
Tier 4 Specialty: You pay 50% per drug
Tier 5 Non-preferred Specialty: You pay 50% per drug
Preventive Care Services, Immunizations You pay nothing for preventive services in-network – deductible does not apply You pay 60% after deductible
Chiropractic Care
(Covered up to 20 visits per year)
You pay 40% after deductible You pay 60% after deductible
Diagnostic X-Ray & Lab Services You pay 40% after deductible You pay 60% after deductible
Inpatient Hospital Services You pay 40% after deductible You pay 60% after deductible
Maternity You pay 40% after deductible You pay 60% after deductible
Physician, Surgical & Medical Services You pay 40% after deductible You pay 60% after deductible
Outpatient Rehabilitation Services; Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 40% after deductible You pay 60% after deductible
Habilitative Services, Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 40% after deductible You pay 60% after deductible

Silver Access Care

Deductible
(What’s This?)
In Network $2,250 individual,
$4,500 family
Out of Network $6,750 individual,
$13,500 family
Annual Out-of-Pocket Maximum
(What’s this?)
In Network $6,850 individual,
$13,700 family
Out of Network $20,550 individual,
$41,100 family
Co-insurance
(What’s this?)
In Network You pay 40%
Out of Network You pay 60%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
In Network $35 copay after deductible
Out of Network You pay 60% after deductible
Specialist Office Visits
In Network You pay 40% after deductible
Out of Network You pay 60% after deductible
Emergency Room Visits
In Network You pay 40% after deductible
Out of Network You pay 40% after deductible
Prescription Drugs
(View Drug List)
In Network Tier 0: You pay $0
Tier 1 Generic: You pay 25% per drug
Tier 2 Preferred Brand: You pay 30% per drug
Tier 3 Non-preferred: You pay 50% per drug
Tier 4 Specialty: You pay 50% per drug
Tier 5 Non-preferred Specialty: You pay 50% per drug
Out of Network Tier 0: You pay $0
Tier 1 Generic: You pay 25% per drug
Tier 2 Preferred Brand: You pay 30% per drug
Tier 3 Non-preferred: You pay 50% per drug
Tier 4 Specialty: You pay 50% per drug
Tier 5 Non-preferred Specialty: You pay 50% per drug
Preventive Care Services, Immunizations
In Network You pay nothing for preventive services in-network – deductible does not apply
Out of Network You pay 60% after deductible
Chiropractic Care
(Covered up to 20 visits per year)
In Network You pay 40% after deductible
Out of Network You pay 60% after deductible
Diagnostic X-Ray & Lab Services
In Network You pay 40% after deductible
Out of Network You pay 60% after deductible
Inpatient Hospital Services
In Network You pay 40% after deductible
Out of Network You pay 60% after deductible
Maternity
In Network You pay 40% after deductible
Out of Network You pay 60% after deductible
Physician, Surgical & Medical Services
In Network You pay 40% after deductible
Out of Network You pay 60% after deductible
Outpatient Rehabilitation Services; Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
In Network You pay 40% after deductible
Out of Network You pay 60% after deductible
Habilitative Services, Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
In Network You pay 40% after deductible
Out of Network You pay 60% after deductible

Get PricingDownload a comparison chart