Sold outside the marketplace. This plan is bought directly from the insurer, so it is not eligible for a premium tax credit. If your income qualifies you for savings, a marketplace plan at the same price will usually cost you less.

NH Local HMO Silver 6000 Standard + $0 Rx list + $0 Virtual Urgent Care

Harvard Pilgrim Health Care · 2026 plan year

Silver
Ind. deductible
$6,000
Family deductible
$12,000
Ind. OOP max
$8,900
Family OOP max
$17,800

More Harvard Pilgrim Health Care plans in NH

Monthly premiums by age

Rating Area 1

AgeIndividualIndividual + tobacco
Under 15$393$393
21$513$652
30$583$740
40$656$833
50$917$1,165
60$1,393$1,770
64 and over$1,540$1,956

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$80.00

Hospital

BenefitIn-network
Emergency Room Services40.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)40.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services40.00% Coinsurance after deductible
Urgent Care Centers or Facilities$60.00

Pharmacy

BenefitIn-network
Generic Drugs$20.00
Non-Preferred Brand Drugs$80.00 Copay after deductible
Off Label Prescription Drugs$350.00 Copay after deductible
Preferred Brand Drugs$40.00
Specialty Drugs$350.00 Copay after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services40.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$40.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental$40.00
Acupuncture$40.00
Allergy Testing40.00% Coinsurance after deductible
Applied Behavior Analysis Based Therapies40.00% Coinsurance after deductible
Bariatric Surgery40.00% Coinsurance after deductible
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Bone Marrow Transplant40.00% Coinsurance after deductible
Chemotherapy40.00% Coinsurance after deductible
Chiropractic Care$40.00
Convenience Care Clinic$40.00
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care40.00% Coinsurance after deductible
Dental Anesthesia40.00% Coinsurance after deductible
Dental Check-Up for ChildrenNot covered
Diabetes Care Management$40.00
Diabetes Education$80.00
Dialysis40.00% Coinsurance after deductible
Durable Medical Equipment40.00% Coinsurance after deductible
Early Intervention ServicesNo charge
Emergency Transportation/Ambulance40.00% Coinsurance after deductible
Eye Glasses for Children50.00%
Gender Affirming Care40.00% Coinsurance after deductible
Habilitation Services$40.00
Hearing Aids50.00%
Home Health Care Services40.00% Coinsurance after deductible
Hospice Services40.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)40.00% Coinsurance after deductible
Infertility TreatmentNot covered
Infusion Therapy40.00% Coinsurance after deductible
Inherited Metabolic Disorders - PKU40.00% Coinsurance after deductible
Inpatient Physician and Surgical Services40.00% Coinsurance after deductible
Inpatient Rehabilitation Services40.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services40.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home CareNot covered
Low Protein Foods40.00% Coinsurance after deductible
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutritional Counseling$40.00
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$40.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)40.00% Coinsurance after deductible
Outpatient Rehabilitation Services$40.00
Prenatal and Postnatal CareNo charge
Private-Duty NursingNot covered
Prosthetic Devices40.00% Coinsurance after deductible
Radiation40.00% Coinsurance after deductible
Reconstructive Surgery40.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$40.00
Rehabilitative Speech Therapy$40.00
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)$40.00
Routine Eye Exam for Children$40.00
Routine Foot Care$80.00
Skilled Nursing Facility40.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services40.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$40.00
Transplant40.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders40.00% Coinsurance after deductible
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
Wigs40.00% Coinsurance after deductible
X-rays and Diagnostic Imaging40.00% Coinsurance after deductible

Service area

This plan covers 1 geographic area.

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