LINK PLATINUM

Mountain Health CO-OP · 2027 plan year

Platinum

Ind. deductible: $1,000
Family deductible: $2,000
Ind. OOP max: $2,500
Family OOP max: $5,000

Other cost-sharing reduction variants for this plan:

Standard Platinum Off Exchange Plan Standard Platinum On Exchange Plan Zero Cost Sharing Plan Variation

More Mountain Health CO-OP plans in ID

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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	No charge

Specialist

Benefit	In-network
Specialist Visit	$80.00

Hospital

Benefit	In-network
Emergency Room Services	10.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	10.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	10.00% Coinsurance after deductible
Urgent Care Centers or Facilities	$80.00

Pharmacy

Benefit	In-network
Specialty Drugs	$300.00
Generic Drugs	$5.00
Non-Preferred Brand Drugs	$250.00
Preferred Brand Drugs	$45.00

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	10.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	No charge

Other

Benefit	In-network
Accidental Dental	10.00% Coinsurance after deductible
Allergy Testing	10.00% Coinsurance after deductible
Chemotherapy	10.00% Coinsurance after deductible
Chiropractic Care	$80.00
Delivery and All Inpatient Services for Maternity Care	10.00% Coinsurance after deductible
Diabetes Education	10.00% Coinsurance after deductible
Dialysis	10.00% Coinsurance after deductible
Durable Medical Equipment	10.00% Coinsurance after deductible
Emergency Transportation/Ambulance	10.00% Coinsurance after deductible
Eye Glasses for Children	No charge
Habilitation Services	10.00% Coinsurance after deductible
Home Health Care Services	10.00% Coinsurance after deductible
Hospice Services	10.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	10.00% Coinsurance after deductible
Infusion Therapy	10.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	10.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	10.00% Coinsurance after deductible
Nutritional Counseling	10.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)	No charge
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	10.00% Coinsurance after deductible
Outpatient Rehabilitation Services	10.00% Coinsurance after deductible
Prenatal and Postnatal Care	10.00% Coinsurance after deductible
Prosthetic Devices	10.00% Coinsurance after deductible
Radiation	10.00% Coinsurance after deductible
Reconstructive Surgery	10.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	$80.00
Rehabilitative Speech Therapy	$80.00
Routine Eye Exam for Children	No charge
Skilled Nursing Facility	10.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	10.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	No charge
Transplant	10.00% Coinsurance after deductible
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	10.00% Coinsurance after deductible

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