ACCESS SILVER

Mountain Health CO-OP · 2027 plan year

Silver
Ind. deductible
$9,000
Family deductible
$18,000
Ind. OOP max
$10,000
Family OOP max
$20,000

Compare with other Silver plans in ID

Side by side: deductibles, out-of-pocket limits and copays.

More Mountain Health CO-OP plans in ID

Monthly premiums by age

Rating Area 3

AgeIndividualIndividual + tobacco
Under 15$358$358
21$467$467
30$531$531
40$597$597
50$835$960
60$1,269$1,459
64 and over$1,402$1,613

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$40.00

Specialist

BenefitIn-network
Specialist Visit$80.00

Hospital

BenefitIn-network
Emergency Room Services40.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)40.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services40.00% Coinsurance after deductible
Urgent Care Centers or Facilities$80.00

Pharmacy

BenefitIn-network
Generic Drugs$10.00
Non-Preferred Brand Drugs$300.00
Preferred Brand Drugs$65.00
Specialty Drugs$350.00

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services40.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$40.00

Other

BenefitIn-network
Accidental Dental40.00% Coinsurance after deductible
Allergy Testing40.00% Coinsurance after deductible
Chemotherapy40.00% Coinsurance after deductible
Chiropractic Care$80.00
Delivery and All Inpatient Services for Maternity Care40.00% Coinsurance after deductible
Diabetes Education40.00% Coinsurance after deductible
Dialysis40.00% Coinsurance after deductible
Durable Medical Equipment40.00% Coinsurance after deductible
Emergency Transportation/Ambulance40.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Habilitation Services40.00% Coinsurance after deductible
Home Health Care Services40.00% Coinsurance after deductible
Hospice Services40.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)40.00% Coinsurance after deductible
Infusion Therapy40.00% Coinsurance after deductible
Inpatient Physician and Surgical Services40.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services40.00% Coinsurance after deductible
Nutritional Counseling40.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)$40.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)40.00% Coinsurance after deductible
Outpatient Rehabilitation Services40.00% Coinsurance after deductible
Prenatal and Postnatal Care40.00% Coinsurance after deductible
Prosthetic Devices40.00% Coinsurance after deductible
Radiation40.00% Coinsurance after deductible
Reconstructive Surgery40.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$80.00
Rehabilitative Speech Therapy$80.00
Routine Eye Exam for ChildrenNo charge
Skilled Nursing Facility40.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services40.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$40.00
Transplant40.00% Coinsurance after deductible
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging40.00% Coinsurance after deductible

Service area

This plan covers 7 geographic areas.

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