Battle Born State Plan Ambetter PCP Referral Required Silver
SilverSummit Healthplan, Inc. · 2027 plan year
Silver
- Ind. deductible
- $7,700
- Family deductible
- $15,400
- Ind. OOP max
- $8,600
- Family OOP max
- $17,200
Compare with other Silver plans in NV
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More SilverSummit Healthplan, Inc. plans in NV
Monthly premiums by age
Rating Area 1
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $327 | $327 |
| 21 | $428 | $492 |
| 30 | $486 | $559 |
| 40 | $547 | $629 |
| 50 | $764 | $879 |
| 60 | $1,162 | $1,336 |
| 64 and over | $1,284 | $1,477 |
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 | $50.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $90.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | 50.00% Coinsurance after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | 50.00% Coinsurance after deductible |
| Mental/Behavioral Health Emergency Room | 50.00% Coinsurance after deductible |
| Mental/Behavioral Health Urgent Care | $50.00 |
| Outpatient Surgery Physician/Surgical Services | 50.00% Coinsurance after deductible |
| Substance Use Disorder Emergency Room | 50.00% Coinsurance after deductible |
| Substance Use Disorder Urgent Care | $50.00 |
| Urgent Care Centers or Facilities | $65.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $3.00 |
| Non-Preferred Brand Drugs | 45.00% Coinsurance after deductible |
| Preferred Brand Drugs | $85.00 Copay after deductible |
| Specialty Drugs | 50.00% Coinsurance after deductible |
| Tier 1b Generic Drugs | $15.00 |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Emergency Transportation/Ambulance | 50.00% Coinsurance after deductible |
| Mental/Behavioral Health ER Physician Fee | 50.00% Coinsurance after deductible |
| Mental/Behavioral Health Inpatient Services | 50.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Other Services | 50.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | $50.00 |
| Substance Use Disorder Emergency Transportation/Ambulance | 50.00% Coinsurance after deductible |
| Substance Use Disorder ER Physician Fee | 50.00% Coinsurance after deductible |
| Substance Use Disorder Outpatient Other Services | 50.00% Coinsurance after deductible |
Other
| Benefit | In-network |
|---|---|
| Accidental Dental | 50.00% Coinsurance after deductible |
| Allergy Testing | $90.00 |
| Bariatric Surgery | 50.00% Coinsurance after deductible |
| Chemotherapy | 50.00% Coinsurance after deductible |
| Chiropractic Care | 50.00% Coinsurance after deductible |
| Delivery and All Inpatient Services for Maternity Care | 50.00% Coinsurance after deductible |
| Diabetes Education | 50.00% Coinsurance after deductible |
| Dialysis | 50.00% Coinsurance after deductible |
| Durable Medical Equipment | 50.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | 50.00% Coinsurance after deductible |
| Eye Glasses for Children | No charge |
| Gender Affirming Care | 50.00% Coinsurance after deductible |
| Habilitation Services | 50.00% Coinsurance after deductible |
| Hearing Aids | 50.00% Coinsurance after deductible |
| Home Health Care Services | 50.00% Coinsurance after deductible |
| Hospice Services | 50.00% Coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs) | 50.00% Coinsurance after deductible |
| Infertility Treatment | 50.00% Coinsurance after deductible |
| Infusion Therapy | 50.00% Coinsurance after deductible |
| Inpatient Physician and Surgical Services | 50.00% Coinsurance after deductible |
| Laboratory Outpatient and Professional Services | $30.00 |
| Nutritional Counseling | $90.00 |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $50.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 50.00% Coinsurance after deductible |
| Outpatient Rehabilitation Services | 50.00% Coinsurance after deductible |
| Prenatal and Postnatal Care | $50.00 |
| Private-Duty Nursing | 50.00% Coinsurance after deductible |
| Prosthetic Devices | 50.00% Coinsurance after deductible |
| Radiation | 50.00% Coinsurance after deductible |
| Reconstructive Surgery | 50.00% Coinsurance after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | 50.00% Coinsurance after deductible |
| Rehabilitative Speech Therapy | 50.00% Coinsurance after deductible |
| Routine Eye Exam for Children | No charge |
| Routine Foot Care | $90.00 |
| Skilled Nursing Facility | 50.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | 50.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | $50.00 |
| Transplant | 50.00% Coinsurance after deductible |
| Treatment for Temporomandibular Joint Disorders | 50.00% Coinsurance after deductible |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $90.00 |
Service area
This plan covers 2 geographic areas.
Open enrollment coming up?
Get notified when it opens — we'll remind you so you don't miss your window.