Molina Silver Saver 94 with Four Free PCP Visits

Molina Healthcare of Utah, Inc.dba Molina Healthcare of Idaho · 2026 plan year

Silver

Ind. deductible: $190
Family deductible: $190
Ind. OOP max: $1,960
Family OOP max: $1,960

Other cost-sharing reduction variants for this plan:

73% AV Level Silver Plan 87% AV Level Silver Plan Limited Cost Sharing Plan Variation Standard Silver Off Exchange Plan Standard Silver On Exchange Plan Zero Cost Sharing Plan Variation

More Molina Healthcare of Utah, Inc.dba Molina Healthcare of Idaho plans in ID

Molina Silver Core 70 Plus with Adult Dental and Vision Molina Gold Enhanced 895 Plus with Adult Dental and Vision Molina Gold Core 1640 Molina Silver Core 70 Molina Gold Enhanced 895

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	$3.00

Specialist

Benefit	In-network
Specialist Visit	$6.00

Hospital

Benefit	In-network
Emergency Room Services	15.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	15.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	15.00% Coinsurance after deductible
Urgent Care Centers or Facilities	$6.00

Pharmacy

Benefit	In-network
Generic Drugs	$3.00
Non-Preferred Brand Drugs	15.00% Coinsurance after deductible
Preferred Brand Drugs	$20.00
Specialty Drugs	20.00% Coinsurance after deductible

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	15.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	$3.00

Other

Benefit	In-network
Habilitation Services	15.00% Coinsurance after deductible
Hospice Services	No charge
Home Health Care Services	15.00% Coinsurance after deductible
Accidental Dental	15.00% Coinsurance after deductible
Allergy Testing	$3.00
Chemotherapy	20.00% Coinsurance after deductible
Chiropractic Care	15.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care	15.00% Coinsurance after deductible
Diabetes Education	No charge
Dialysis	$6.00
Durable Medical Equipment	15.00% Coinsurance after deductible
Emergency Transportation/Ambulance	15.00% Coinsurance after deductible
Eye Glasses for Children	No charge
Imaging (CT/PET Scans, MRIs)	15.00% Coinsurance after deductible
Infusion Therapy	15.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	15.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	15.00% Coinsurance after deductible
Nutritional Counseling	No charge
Other Practitioner Office Visit (Nurse, Physician Assistant)	$3.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	15.00% Coinsurance after deductible
Outpatient Rehabilitation Services	15.00% Coinsurance after deductible
Prenatal and Postnatal Care	No charge
Prosthetic Devices	15.00% Coinsurance after deductible
Radiation	15.00% Coinsurance after deductible
Reconstructive Surgery	15.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	15.00% Coinsurance after deductible
Rehabilitative Speech Therapy	15.00% Coinsurance after deductible
Routine Eye Exam for Children	No charge
Skilled Nursing Facility	15.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	15.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	$3.00
Transplant	15.00% Coinsurance after deductible
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	15.00% Coinsurance after deductible

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