ACCESS GOLD
Mountain Health CO-OP · 2027 plan year
Gold
- Ind. deductible
- $2,000
- Family deductible
- $4,000
- Ind. OOP max
- $7,000
- Family OOP max
- $14,000
Compare with other Gold plans in ID
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More Mountain Health CO-OP plans in ID
Monthly premiums by age
Rating Area 3
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $385 | $385 |
| 21 | $503 | $503 |
| 30 | $571 | $571 |
| 40 | $643 | $643 |
| 50 | $899 | $1,034 |
| 60 | $1,366 | $1,571 |
| 64 and over | $1,510 | $1,736 |
Live premium estimate
Benefits & cost sharing
Primary Care
| Benefit | In-network |
|---|---|
| Preventive Care/Screening/Immunization | No charge |
| Primary Care Visit to Treat an Injury or Illness | $40.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $80.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | 30.00% Coinsurance after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | 30.00% Coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | 30.00% Coinsurance after deductible |
| Urgent Care Centers or Facilities | $80.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $5.00 |
| Non-Preferred Brand Drugs | $250.00 |
| Preferred Brand Drugs | $45.00 |
| Specialty Drugs | $300.00 |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 30.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | $40.00 |
Other
| Benefit | In-network |
|---|---|
| Accidental Dental | 30.00% Coinsurance after deductible |
| Allergy Testing | 30.00% Coinsurance after deductible |
| Chemotherapy | 30.00% Coinsurance after deductible |
| Chiropractic Care | $80.00 |
| Delivery and All Inpatient Services for Maternity Care | 30.00% Coinsurance after deductible |
| Diabetes Education | 30.00% Coinsurance after deductible |
| Dialysis | 30.00% Coinsurance after deductible |
| Durable Medical Equipment | 30.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | 30.00% Coinsurance after deductible |
| Eye Glasses for Children | No charge |
| Habilitation Services | 30.00% Coinsurance after deductible |
| Home Health Care Services | 30.00% Coinsurance after deductible |
| Hospice Services | 30.00% Coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs) | 30.00% Coinsurance after deductible |
| Infusion Therapy | 30.00% Coinsurance after deductible |
| Inpatient Physician and Surgical Services | 30.00% Coinsurance after deductible |
| Laboratory Outpatient and Professional Services | 30.00% Coinsurance after deductible |
| Nutritional Counseling | 30.00% Coinsurance after deductible |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $40.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 30.00% Coinsurance after deductible |
| Outpatient Rehabilitation Services | 30.00% Coinsurance after deductible |
| Prenatal and Postnatal Care | 30.00% Coinsurance after deductible |
| Prosthetic Devices | 30.00% Coinsurance after deductible |
| Radiation | 30.00% Coinsurance after deductible |
| Reconstructive Surgery | 30.00% Coinsurance after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $80.00 |
| Rehabilitative Speech Therapy | $80.00 |
| Routine Eye Exam for Children | No charge |
| Skilled Nursing Facility | 30.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | 30.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | $40.00 |
| Transplant | 30.00% Coinsurance after deductible |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | 30.00% Coinsurance after deductible |
Service area
This plan covers 7 geographic areas.
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