Anthem Silver X 0 ($0 Virtual PCP + $0 Select Drugs + Incentives) S06

HMO Colorado, Inc., DBA HMO Nevada · 2027 plan year

Silver
Ind. deductible
$0
Family deductible
$0
Ind. OOP max
$1,800
Family OOP max
$3,600

More HMO Colorado, Inc., DBA HMO Nevada plans in NV

Live premium estimate

$

Benefits & cost sharing

Primary Care

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

Specialist

BenefitIn-network
Specialist Visit$25.00

Hospital

BenefitIn-network
Emergency Room Services$75.00 + 20.00%
Inpatient Hospital Services (e.g., Hospital Stay)$150.00 Copay per Stay + 30.00%
Outpatient Surgery Physician/Surgical Services20.00%
Urgent Care Centers or Facilities$50.00

Pharmacy

BenefitIn-network
Generic Drugs$5.00
Non-Preferred Brand Drugs30.00%
Preferred Brand Drugs$30.00
Specialty Drugs40.00%

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services$150.00 Copay per Stay + 30.00%
Mental/Behavioral Health Outpatient Services20.00%

Other

BenefitIn-network
Accidental Dental20.00%
Allergy Testing20.00%
Bariatric Surgery$150.00 + 30.00%
Chemotherapy20.00%
Chiropractic Care20.00%
Delivery and All Inpatient Services for Maternity Care$150.00 + 30.00%
Diabetes Education20.00%
Dialysis20.00%
Durable Medical Equipment20.00%
Emergency Transportation/Ambulance20.00%
Eye Glasses for ChildrenNo charge
Gender Affirming Care20.00%
Habilitation Services20.00%
Hearing Aids20.00%
Home Health Care Services20.00%
Hospice Services20.00%
Imaging (CT/PET Scans, MRIs)$200.00 + 20.00%
Infertility Treatment20.00%
Infusion Therapy20.00%
Inpatient Physician and Surgical Services20.00%
Laboratory Outpatient and Professional Services20.00%
Nutritional Counseling20.00%
Other Practitioner Office Visit (Nurse, Physician Assistant)No charge
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)20.00%
Outpatient Rehabilitation Services20.00%
Prenatal and Postnatal Care20.00%
Private-Duty Nursing20.00%
Prosthetic Devices20.00%
Radiation20.00%
Reconstructive Surgery$150.00 + 30.00%
Rehabilitative Occupational and Rehabilitative Physical Therapy20.00%
Rehabilitative Speech Therapy20.00%
Routine Eye Exam for ChildrenNo charge
Skilled Nursing Facility20.00%
Substance Abuse Disorder Inpatient Services$150.00 Copay per Stay + 30.00%
Substance Abuse Disorder Outpatient Services20.00%
Transplant$150.00 + 30.00%
Treatment for Temporomandibular Joint Disorders20.00%
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging$50.00

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