SimpliveraCoverage Companion

Low Premium Silver HMO 6000 $35 PCP

CareSource Nevada Co. · 2027 plan year

Silver
Ind. deductible
$6,000
Family deductible
$12,000
Ind. OOP max
$7,850
Family OOP max
$15,700

Other cost-sharing reduction variants for this plan:

87% AV Level Silver Plan94% AV Level Silver PlanLimited Cost Sharing Plan VariationStandard Silver Off Exchange PlanStandard Silver On Exchange PlanZero Cost Sharing Plan Variation

More CareSource Nevada Co. plans in NV

Core Bronze HMO 8500 $50 PCPSilver HMO 6000 $0 Diabetes care

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$35.00

Specialist

BenefitIn-network
Specialist Visit$70.00

Hospital

BenefitIn-network
Emergency Room Services30.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)$450.00 Copay per Stay after deductible
Outpatient Surgery Physician/Surgical Services30.00% Coinsurance after deductible
Urgent Care Centers or Facilities$50.00

Pharmacy

BenefitIn-network
Generic Drugs$5.00
Non-Preferred Brand Drugs50.00% Coinsurance after deductible
Preferred Brand Drugs30.00% Coinsurance after deductible
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services$450.00 Copay per Stay after deductible
Mental/Behavioral Health Outpatient Services$35.00

Other

BenefitIn-network
Accidental Dental30.00% Coinsurance after deductible
Allergy Testing$70.00
Bariatric Surgery30.00% Coinsurance after deductible
Chemotherapy30.00% Coinsurance after deductible
Chiropractic Care30.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care$450.00 Copay after deductible
Diabetes Education30.00% Coinsurance after deductible
Dialysis30.00% Coinsurance after deductible
Durable Medical Equipment30.00% Coinsurance after deductible
Emergency Transportation/Ambulance30.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Gender Affirming Care30.00% Coinsurance after deductible
Habilitation Services30.00% Coinsurance after deductible
Hearing Aids30.00% Coinsurance after deductible
Home Health Care Services30.00% Coinsurance after deductible
Hospice Services30.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)$250.00 Copay after deductible
Infertility Treatment30.00% Coinsurance after deductible
Infusion Therapy30.00% Coinsurance after deductible
Inpatient Physician and Surgical ServicesNo Charge after deductible
Laboratory Outpatient and Professional Services$45.00
Nutritional Counseling30.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)$35.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)30.00% Coinsurance after deductible
Outpatient Rehabilitation Services30.00% Coinsurance after deductible
Prenatal and Postnatal Care$70.00
Private-Duty Nursing30.00% Coinsurance after deductible
Prosthetic Devices30.00% Coinsurance after deductible
Radiation30.00% Coinsurance after deductible
Reconstructive Surgery30.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy30.00% Coinsurance after deductible
Rehabilitative Speech Therapy30.00% Coinsurance after deductible
Routine Eye Exam for ChildrenNo charge
Skilled Nursing Facility$450.00 Copay per Stay after deductible
Substance Abuse Disorder Inpatient Services$450.00 Copay per Stay after deductible
Substance Abuse Disorder Outpatient Services$35.00
Transplant$450.00 Copay after deductible
Treatment for Temporomandibular Joint Disorders30.00% Coinsurance after deductible
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging$200.00 Copay after deductible

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