Silver 94 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 94 Engage

In Network Out of Network
Deductible
(What’s This?)
Individual: $0
Family: $0
Individual: $10,000
Family: $20,000
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $1,100
Family: $2,200
Individual: $30,000
Family: $60,000
Co-insurance
(What’s this?)
You pay 20% You pay 50%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
You pay $15 copay per visit You pay 40%
Specialist Office Visit
You pay $25 copay per visit You pay 40% after deductible
Emergency Room Visits You pay 20% after deductible You pay 20% 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 20% per drug
Tier 3 Non-preferred: You pay 25% per drug
Tier 4 Specialty: You pay 25% per drug
Tier 0: You pay $0
Tier 1 Generic: You pay 40% coinsurance after deductible
Tier 2 Preferred Brand: You pay 40% coinsurance after deductible
Tier 3 Non-preferred: You pay 40% coinsurance after deductible
Tier 4 Specialty: You pay 40% coinsurance after deductible
Preventive Care Services, Immunizations You pay nothing for preventive services in-network–deductible does not apply You pay 40% coinsurance after deductible
Chiropractic Care
(Covered up to 20 visits per year)
You pay 20% after deductible You pay 40% coinsurance after deductible
Diagnostic X-Ray & Lab Services You pay 20% after deductible You pay 40% coinsurance after deductible
Inpatient Hospital Services You pay 20% after deductible You pay 40% coinsurance after deductible
Maternity You pay 20% after deductible You pay 40% coinsurance after deductible
Physician, Surgical & Medical Services You pay 20% after deductible You pay 40% coinsurance after deductible
Outpatient Rehabilitation Services; Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 20% after deductible You pay 40% coinsurance after deductible
Habilitative Services, Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 20% after deductible You pay 40% coinsurance after deductible

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Silver 94 Engage

Tier 1 Network Tier 2 Network Out of Network
Deductible
(What’s This?)
Individual: $0
Family: $0
Individual: $250
Family: $500
Individual: $10,000
Family: $20,000
Annual Out-of-Pocket Maximum
(What’s this?)
Individual: $1,100
Family: $2,200
Individual: $1,100
Family: $2,200
Individual: $30,000
Family: $60,000
Coinsurance
(What’s this?)
You pay 20% You pay 20% You pay 40%
Primary Care Provider and Non-specialist Office Visits
(Find a Provider)
You pay $10 copay per visit You pay $10 copay per visit after deductible You pay 40% after deductible
Specialist Office Visits You pay $10 copay per visit You pay $10 copay per visit after deductible You pay 40% after deductible
Emergency Room Visits You pay $100 copay per visit You pay $100 copay per visit You pay $100 copay 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 15% per drug
Tier 3 Non-preferred: You pay 20% per drug
Tier 4 Specialty: You pay 20% per drug after
Tier 0: You pay $0
Tier 1 Generic: You pay $5 per drug
Tier 2 Preferred Brand: You pay 15% per drug
Tier 3 Non-preferred: You pay 20% per drug
Tier 4 Specialty: You pay 20% per drug
Tier 0: You pay $0
Tier 1 Generic: You pay 40% coinsurance after deductible
Tier 2 Preferred Brand: You pay 40% coinsurance after deductible
Tier 3 Non-preferred: You pay 40% coinsurance after deductible
Tier 4 Specialty: You pay 40% coinsurance after deductible
Preventive Care Services, Immunizations You pay nothing for preventive services in-network–deductible does not apply You pay 20% after deductible You pay 40% coinsurance after deductible
Chiropractic Care
(Covered up to 20 visits per year)
You pay 20% after deductible You pay 20% after deductible You pay 40% coinsurance after deductible
Diagnostic X-Ray & Lab Services You pay 20% after deductible You pay 20% after deductible You pay 40% coinsurance after deductible
Inpatient Hospital Services You pay 20% after deductible You pay 20% after deductible You pay 40% coinsurance after deductible
Maternity You pay 20% after deductible You pay 20% after deductible You pay 40% coinsurance after deductible
Physician, Surgical & Medical Services You pay 20% after deductible You pay 20% after deductible You pay 40% coinsurance after deductible
Outpatient Rehabilitation Services; Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 20% after deductible You pay 20% after deductible You pay 40% coinsurance after deductible
Habilitative Services, Physical, Occupational, Speech
(Covered up to 20 visits per year, all types combined)
You pay 20% after deductible You pay 20% after deductible You pay 40% coinsurance after deductible

Get Pricing Download a PDF comparison chart