ConnectPlus $0 Silver

Avera Health Plans · 2027 plan year

Silver
Ind. medical deductible
$0
Rx deductible (separate)
$100
Family deductible
$0
Ind. OOP max
$11,500
Family OOP max
$23,000

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

Compare with other Silver plans in SD

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

Monthly premiums by age

Rating Area 1

AgeIndividualIndividual + tobacco
Under 15$605$605
21$791$910
30$898$1,033
40$1,011$1,163
50$1,413$1,625
60$2,148$2,470
64 and over$2,374$2,730

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$100.00

Hospital

BenefitIn-network
Emergency Room Services$1,500.00
Inpatient Hospital Services (e.g., Hospital Stay)$3500.00 Copay per Stay
Outpatient Surgery Physician/Surgical Services40.00%
Urgent Care Centers or Facilities$60.00

Pharmacy

BenefitIn-network
Generic Drugs$30.00
Non-Preferred Brand Drugs$150.00 Copay after deductible
Preferred Brand Drugs$50.00
Specialty Drugs40.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services$3500.00 Copay per Stay
Mental/Behavioral Health Outpatient Services$40.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental40.00%
AcupunctureNot covered
Allergy Testing40.00%
Bariatric Surgery40.00%
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNo charge
Chemotherapy40.00%
Chiropractic Care$40.00
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care$3,500.00
Dental Check-Up for ChildrenNo charge
Diabetes Education40.00%
Dialysis40.00%
Durable Medical Equipment40.00%
Emergency Transportation/Ambulance40.00%
Eye Glasses for ChildrenNo charge
Habilitation Services$40.00
Hearing AidsNot covered
Home Health Care Services40.00%
Hospice Services40.00%
Imaging (CT/PET Scans, MRIs)$900.00
Infertility TreatmentNot covered
Infusion Therapy40.00%
Inpatient Physician and Surgical Services40.00%
Laboratory Outpatient and Professional Services$40.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - Child50.00%
Nutritional CounselingNot covered
Orthodontia - AdultNot covered
Orthodontia - Child50.00%
Other Practitioner Office Visit (Nurse, Physician Assistant)$40.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)$1,500.00
Outpatient Rehabilitation Services$40.00
Prenatal and Postnatal CareNo charge
Private-Duty Nursing40.00%
Prosthetic Devices40.00%
Radiation40.00%
Reconstructive Surgery40.00%
Rehabilitative Occupational and Rehabilitative Physical Therapy$40.00
Rehabilitative Speech Therapy$40.00
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility40.00%
Substance Abuse Disorder Inpatient Services$3500.00 Copay per Stay
Substance Abuse Disorder Outpatient Services$40.00
Transplant40.00%
Treatment for Temporomandibular Joint Disorders40.00%
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging$40.00

Plan rules

Service area

This plan covers 16 geographic areas.

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