Ambetter Cascade Silver

Coordinated Care Corporation · 2027 plan year

Silver
Ind. deductible
$2,800
Family deductible
$5,600
Ind. OOP max
$11,200
Family OOP max
$22,400

Compare with other Silver plans in WA

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

More Coordinated Care Corporation plans in WA

Monthly premiums by age

Rating Area 6 — the lowest-priced of the 9 areas this plan covers. Premiums differ by area.

AgeIndividual
Under 15$460
21$601
30$682
40$768
50$1,074
60$1,632
64 and over$1,804

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$20.00

Specialist

BenefitIn-network
Specialist Visit$65.00

Hospital

BenefitIn-network
Emergency Room Services$800.00 Copay after deductible
Inpatient Hospital Services (e.g., Hospital Stay)$800.00 Copay per Day after deductible
Mental/Behavioral Health Emergency Room$800.00 Copay after deductible
Mental/Behavioral Health Urgent Care$65.00
Outpatient Surgery Physician/Surgical Services$200.00 Copay after deductible
Substance Use Disorder Emergency Room$800.00 Copay after deductible
Substance Use Disorder Urgent Care$65.00
Urgent Care Centers or Facilities$65.00

Pharmacy

BenefitIn-network
Generic Drugs$25.00
Non-Preferred Brand Drugs$250.00 Copay after deductible
Preferred Brand Drugs$75.00
Specialty Drugs$250.00 Copay after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Emergency Transportation/Ambulance$800.00 Copay after deductible
Mental/Behavioral Health ER Physician FeeNo Charge after deductible
Mental/Behavioral Health Inpatient Services$800.00 Copay per Day after deductible
Mental/Behavioral Health Outpatient Other Services$20.00
Mental/Behavioral Health Outpatient Services$20.00
Substance Use Disorder Emergency Transportation/Ambulance$800.00 Copay after deductible
Substance Use Disorder ER Physician FeeNo Charge after deductible
Substance Use Disorder Outpatient Other Services$20.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNo charge
Accidental Dental$600.00 Copay after deductible
Acupuncture$20.00
Allergy Testing$65.00
Chemotherapy30.00% Coinsurance after deductible
Chiropractic Care$20.00
Cosmetic Surgery$800.00 Copay after deductible
Delivery and All Inpatient Services for Maternity Care$800.00 Copay after deductible
Dental Anesthesia$600.00 Copay after deductible
Diabetes Care ManagementNo charge
Diabetes EducationNo charge
Dialysis$600.00 Copay after deductible
Durable Medical Equipment30.00% Coinsurance after deductible
Emergency Transportation/Ambulance$375.00
Eye Glasses for ChildrenNo charge
Gender Affirming Care$800.00 Copay after deductible
Habilitation Services$40.00
Hearing Aids30.00%
Hearing Exams$20.00
Home Health Care Services$30.00
Hospice Services$30.00
Imaging (CT/PET Scans, MRIs)30.00% Coinsurance after deductible
Infertility Treatment$600.00 Copay after deductible
Infusion Therapy$600.00 Copay after deductible
Inherited Metabolic Disorder - PKU$40.00
Inpatient Physician and Surgical ServicesNo Charge after deductible
Laboratory Outpatient and Professional Services$40.00
Nutritional CounselingNo charge
Other Practitioner Office Visit (Nurse, Physician Assistant)$20.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)$600.00 Copay after deductible
Outpatient Rehabilitation Services$40.00
Prenatal and Postnatal CareNo charge
Prosthetic Devices30.00% Coinsurance after deductible
Radiation$600.00 Copay after deductible
Reconstructive Surgery$800.00 Copay after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$40.00
Rehabilitative Speech Therapy$40.00
Routine Eye Exam for ChildrenNo charge
Routine Foot Care$65.00
Skilled Nursing Facility$800.00 Copay per Day after deductible
Substance Abuse Disorder Inpatient Services$800.00 Copay per Day after deductible
Substance Abuse Disorder Outpatient Services$20.00
Transplant$800.00 Copay after deductible
Treatment for Temporomandibular Joint Disorders$600.00 Copay after deductible
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging$65.00

Service area

This plan covers 34 geographic areas.

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