SimpliveraCoverage Companion

HMO Copayment 30, Silver, ST, INN, HMO Network, Dep25

CDPHP · 2026 plan year

Silver
Ind. medical deductible
$2,160
Rx deductible (separate)
Not listed
Family deductible
$4,320
Ind. OOP max
$8,100
Family OOP max
$16,200

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

Other cost-sharing reduction variants for this plan:

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

More CDPHP plans in NY

HDHMO HSA Qualified 40 Bronze, ST, INN, HMO Network, Dep29HDHMO HSA Qualified 40 Child Only, Bronze, ST, INN, HMO NetworkHDHMO HSA Qualified 40 Bronze, ST, INN, HMO Network, Dep25HDHMO HSA Qualified 45, Bronze, NS, INN, HMO Network, Dep29, Adult Vision, Lasik, WellnessHMO Triple Zero Copayment 24, Gold, NS, INN, HMO Network, Dep25, Adult Vision, Lasik, Wellness

Live premium estimate

$

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