Silver 73 Engage

Available only in Benewah, Bonner, Boundary, Kootenai and Shoshone Counties, our Engage plans feature our lowest monthly premiums. Each Engage plan offers two tiers of in-network providers to provide a good balance of choice and cost savings. Have questions? Just give us a call at 855-447-2900.

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Silver 73 Engage

Tier 1 Network Tier 2 Network Out of Network
Deductible
(What’s This?)
Individual: $2,500
Family: $5,000
Individual: $2,800
Family: $5,600
Individual: $25,000
Family: $50,000
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $5,500
Family: $11,000
Individual: $5,500
Family: $11,000
Individual: $50,000
Family: $100,000
Coinsurance
(What’s this?)
You pay 40% 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 $30 copay per visit after deductible You pay 60% coinsurance after deductible
Specialist Office Visits You pay $40 copay per visit You pay $40 copay per visit after deductible You pay 60% coinsurance after deductible
Emergency Room Visits You pay $350 copay per visit You pay $350 copay per visit You pay $350 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 25% per drug after deductible
Tier 3 Non-preferred: You pay 30% per drug after deductible
Tier 4 Specialty: You pay 50% per drug after deductible
Tier 0: You pay $0
Tier 1 Generic: You pay $10 per drug
Tier 2 Preferred Brand: You pay 25% per drug after deductible
Tier 3 Non-preferred: You pay 30% 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 40% after deductible You pay 60% coinsurance after deductible
Chiropractic Care
(Covered up to 20 visits per year)
You pay 40% after deductible You pay 40% after deductible You pay 60% coinsurance after deductible
Diagnostic X-Ray & Lab Services You pay 40% after deductible You pay 40% after deductible You pay 60% coinsurance after deductible
Inpatient Hospital Services You pay 40% after deductible You pay 40% after deductible You pay 60% coinsurance after deductible
Maternity You pay 40% after deductible You pay 40% after deductible You pay 60% coinsurance after deductible
Physician, Surgical & Medical Services You pay 40% after deductible 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 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 40% after deductible You pay 60% coinsurance after deductible

Bronze Engage

Deductible
(What’s This?)
Tier 1 Network Individual: $2,500
Family: $5,000
Tier 2 Network Individual: $2,800
Family: $5,600
Out of Network Individual: $25,000
Family: $50,000
Annual Out-of-Pocket Maximum
(What’s this?)
Tier 1 Network Individual: $5,500
Family: $11,000
Tier 2 Network Individual: $5,500
Family: $11,000
Out of Network Individual: $50,000
Family: $100,000
Co-insurance
(What’s this?)
Tier 1 Network You pay 40%
Tier 2 Network You pay 40%
Out of Network You pay 60%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
Tier 1 Network You pay $30 copay per visit
Tier 2 Network You pay $30 copay per visit after deductible
Out of Network You pay 60% coinsurance after deductible
Specialist Office Visits
Tier 1 Network You pay $40 copay per visit
Tier 2 Network You pay $40 copay per visit after deductible
Out of Network You pay 60% coinsurance after deductible
Emergency Room Visits
Tier 1 Network You pay $350 copay per visit
Tier 2 Network You pay $350 copay per visit
Out of Network You pay $350 copay per visit
Prescription Drugs
(View Drug List)
Tier 1 Network Tier 0: You pay $0
Tier 1 Generic: You pay $10 per drug
Tier 2 Preferred Brand: You pay 25% per drug after deductible
Tier 3 Non-preferred: You pay 30% per drug after deductible
Tier 4 Specialty: You pay 50% per drug after deductible
Tier 2 Network Tier 0: You pay $0
Tier 1 Generic: You pay $10 per drug
Tier 2 Preferred Brand: You pay 25% per drug after deductible
Tier 3 Non-preferred: You pay 30% 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
Tier 1 Network You pay nothing for preventive services in-network–deductible does not apply
Tier 2 Network You pay 40% coinsurance after deductible
Out of Network You pay 60% coinsurance after deductible
Chiropractic Care
(Covered up to 20 visits per year)
Tier 1 Network You pay 40% coinsurance after deductible
Tier 2 Network You pay 40% coinsurance after deductible
Out of Network You pay 60% coinsurance after deductible
Diagnostic X-Ray & Lab Services
Tier 1 Network You pay 40% coinsurance after deductible
Tier 2 Network You pay 40% coinsurance after deductible
Out of Network You pay 60% coinsurance after deductible
Inpatient Hospital Services
Tier 1 Network You pay 40% coinsurance after deductible
Tier 2 Network You pay 40% coinsurance after deductible
Out of Network You pay 60% coinsurance after deductible
Maternity
Tier 1 Network You pay 40% coinsurance after deductible
Tier 2 Network You pay 40% coinsurance after deductible
Out of Network You pay 60% coinsurance after deductible
Physician, Surgical & Medical Services
Tier 1 Network You pay 40% coinsurance after deductible
Tier 2 Network You pay 40% coinsurance 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)
Tier 1 Network You pay 40% coinsurance after deductible
Tier 2 Network You pay 40% coinsurance 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)
Tier 1 Network You pay 40% coinsurance after deductible
Tier 2 Network You pay 40% coinsurance after deductible
Out of Network You pay 60% coinsurance after deductible

Get Pricing Download a PDF comparison chart