Value Silver 3500 Medical Deductible

Select Health · 2027 plan year

Silver
Ind. medical deductible
$3,500
Rx deductible (separate)
$1,250
Family deductible
$7,000
Ind. OOP max
$10,000
Family OOP max
$20,000

This plan sets a separate deductible for prescription drugs. The medical deductible shown does not cover prescriptions; they have their own.

Compare with other Silver plans in UT

Side by side: deductibles, out-of-pocket limits and copays.

Monthly premiums by age

Rating Area 3 — the lowest-priced of the 3 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$344$344
21$434$434
30$603$603
40$642$687
50$923$1,015
60$1,302$1,588
64 and over$1,302$1,588

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$40.00

Specialist

BenefitIn-network
Specialist Visit$60.00

Hospital

BenefitIn-network
Emergency Room Services$600.00 Copay after deductible
Inpatient Hospital Services (e.g., Hospital Stay)40.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services40.00% Coinsurance after deductible
Urgent Care Centers or Facilities$60.00

Pharmacy

BenefitIn-network
Generic Drugs$25.00
Non-Preferred Brand Drugs50.00% Coinsurance after deductible
Preferred Brand Drugs25.00% Coinsurance after deductible
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services40.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$40.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental40.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing$60.00
Autism Spectrum Disorders40.00% Coinsurance after deductible
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Chemotherapy50.00% Coinsurance after deductible
Chiropractic CareNot covered
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care40.00% Coinsurance after deductible
Dental Check-Up for Children$60.00
Diabetes Education40.00% Coinsurance after deductible
Dialysis40.00% Coinsurance after deductible
Durable Medical Equipment40.00% Coinsurance after deductible
Emergency Transportation/Ambulance40.00% Coinsurance after deductible
Eye Glasses for Children40.00% Coinsurance after deductible
Gender Affirming CareNot covered
Habilitation Services$40.00
Hearing AidsNot covered
Home Health Care Services40.00% Coinsurance after deductible
Hospice Services40.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)40.00% Coinsurance after deductible
Infertility TreatmentNot covered
Infusion Therapy50.00% Coinsurance after deductible
Inherited Metabolic Disorder - PKU$60.00
Inpatient Physician and Surgical Services40.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services$25.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutritional Counseling40.00% Coinsurance after deductible
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$40.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)40.00% Coinsurance after deductible
Outpatient Rehabilitation Services$40.00
Prenatal and Postnatal Care$40.00
Private-Duty Nursing40.00% Coinsurance after deductible
Prosthetic Devices40.00% Coinsurance after deductible
Radiation40.00% Coinsurance after deductible
Reconstructive Surgery40.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$60.00 Copay after deductible
Rehabilitative Speech Therapy$60.00 Copay after deductible
Routine Dental Services (Adult)$60.00
Routine Eye Exam (Adult)$60.00
Routine Eye Exam for Children$60.00
Routine Foot CareNot covered
Skilled Nursing Facility40.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services40.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$40.00
Transplant40.00% Coinsurance after deductible
Treatment for Temporomandibular Joint DisordersNot covered
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging$50.00

Plan rules

Service area

This plan covers 9 geographic areas.

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