Value Silver 5500 Medical Deductible - No deductible for office visits
SelectHealth, Inc. · 2027 plan year
Silver
- Ind. medical deductible
- $5,000
- Rx deductible (separate)
- $1,750
- Family deductible
- $10,000
- Ind. OOP max
- $9,000
- Family OOP max
- $18,000
This plan sets a separate deductible for prescription drugs. The medical deductible shown does not cover prescriptions; they have their own.
Other cost-sharing reduction variants for this plan:
More SelectHealth, Inc. plans in NV
Med Exp Bronze 10500 Health Deductible - HSA EligibleValue Gold 1500 Medical Deductible - No deductible for office visitsValue Silver 7500 Health Deductible - No deductible for office visitsValue Exp Bronze 7500 Medical Deductible - HSA EligibleValue Exp Bronze 10500 Health Deductible - HSA Eligible
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Benefits & cost sharing
Primary Care
| Benefit | In-network |
|---|---|
| Preventive Care/Screening/Immunization | No charge |
| Primary Care Visit to Treat an Injury or Illness | $20.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $50.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | $750.00 Copay after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | 40.00% Coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | 40.00% Coinsurance after deductible |
| Urgent Care Centers or Facilities | $50.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $25.00 |
| Non-Preferred Brand Drugs | 50.00% Coinsurance after deductible |
| Preferred Brand Drugs | 25.00% Coinsurance after deductible |
| Specialty Drugs | 50.00% Coinsurance after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 40.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | $30.00 |
Other
| Benefit | In-network |
|---|---|
| Prosthetic Devices | 40.00% Coinsurance after deductible |
| Radiation | 40.00% Coinsurance after deductible |
| Accidental Dental | $750.00 Copay after deductible |
| Allergy Testing | $50.00 |
| Bariatric Surgery | 40.00% Coinsurance after deductible |
| Chemotherapy | 50.00% Coinsurance after deductible |
| Chiropractic Care | $20.00 |
| Delivery and All Inpatient Services for Maternity Care | 40.00% Coinsurance after deductible |
| Diabetes Education | $20.00 |
| Dialysis | 40.00% Coinsurance after deductible |
| Durable Medical Equipment | 40.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | 40.00% Coinsurance after deductible |
| Eye Glasses for Children | No charge |
| Gender Affirming Care | 40.00% Coinsurance after deductible |
| Habilitation Services | $50.00 Copay after deductible |
| Hearing Aids | 40.00% Coinsurance after deductible |
| Home Health Care Services | 40.00% Coinsurance after deductible |
| Hospice Services | 40.00% Coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs) | $475.00 Copay after deductible |
| Infertility Treatment | 50.00% Coinsurance after deductible |
| Infusion Therapy | 40.00% Coinsurance after deductible |
| Inpatient Physician and Surgical Services | 40.00% Coinsurance after deductible |
| Laboratory Outpatient and Professional Services | $20.00 |
| Nutritional Counseling | $20.00 |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $20.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 40.00% Coinsurance after deductible |
| Outpatient Rehabilitation Services | $50.00 |
| Prenatal and Postnatal Care | $20.00 |
| Private-Duty Nursing | 40.00% Coinsurance after deductible |
| Reconstructive Surgery | 40.00% Coinsurance after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | 40.00% Coinsurance after deductible |
| Rehabilitative Speech Therapy | 40.00% Coinsurance after deductible |
| Routine Eye Exam for Children | No charge |
| Skilled Nursing Facility | 40.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | 40.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | $30.00 |
| Transplant | 40.00% Coinsurance after deductible |
| Treatment for Temporomandibular Joint Disorders | 40.00% Coinsurance after deductible |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $100.00 |
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