MyHPN Silver 1.1

Health Plan of Nevada, Inc. · 2027 plan year

Silver
Ind. medical deductible
$100
Rx deductible (separate)
$200
Family deductible
$200
Ind. OOP max
$1,600
Family OOP max
$3,200

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

More Health Plan of Nevada, Inc. plans in NV

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$5.00

Specialist

BenefitIn-network
Specialist Visit$10.00

Hospital

BenefitIn-network
Emergency Room Services$650.00
Inpatient Hospital Services (e.g., Hospital Stay)30.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services30.00% Coinsurance after deductible
Urgent Care Centers or Facilities$50.00

Pharmacy

BenefitIn-network
Generic Drugs$15.00
Non-Preferred Brand Drugs30.00% Coinsurance after deductible
Preferred Brand Drugs$50.00
Prescription Drugs Other50.00% Coinsurance after deductible
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services30.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$5.00

Other

BenefitIn-network
Accidental Dental30.00% Coinsurance after deductible
Allergy Testing30.00% Coinsurance after deductible
Bariatric Surgery30.00% Coinsurance after deductible
Chemotherapy30.00% Coinsurance after deductible
Chiropractic Care$5.00
Clinical Trials$5.00
Delivery and All Inpatient Services for Maternity Care30.00% Coinsurance after deductible
Diabetes Care Management$5.00
Diabetes Education$5.00
Diagnostic Breast Cancer ImagingNo charge
Dialysis30.00% Coinsurance after deductible
Durable Medical Equipment$150.00 + 50.00%
Emergency Transportation/Ambulance$650.00
Eye Glasses for ChildrenNo charge
Gender Affirming Care$5.00
Habilitation Services30.00% Coinsurance after deductible
Hearing Aids$150.00 + 50.00%
Home Health Care Services$5.00
Hospice Services30.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)30.00% Coinsurance after deductible
Infertility Treatment$10.00
Infusion Therapy30.00% Coinsurance after deductible
Inherited Metabolic Disorder - PKUNo charge
Inpatient Physician and Surgical Services30.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services$25.00
Nutritional Counseling$5.00
Other Practitioner Office Visit (Nurse, Physician Assistant)No charge
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)30.00% Coinsurance after deductible
Outpatient Rehabilitation Services30.00% Coinsurance after deductible
Prenatal and Postnatal Care$5.00
Private-Duty Nursing$5.00
Prosthetic Devices$500.00
Radiation30.00% Coinsurance after deductible
Reconstructive Surgery30.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy30.00% Coinsurance after deductible
Rehabilitative Speech Therapy30.00% Coinsurance after deductible
Routine Eye Exam for ChildrenNo charge
Skilled Nursing Facility30.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services30.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$5.00
Transplant30.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders50.00%
Virtual Visits/Now ClinicNo charge
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging30.00% Coinsurance after deductible

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