Colorado Access Choice EPO Silver 4000 Rx Copay 94%

Access Connected Care Partners · 2027 plan year

Silver

Ind. deductible: $100
Family deductible: $200
Ind. OOP max: $1,300
Family OOP max: $2,600

Other cost-sharing reduction variants for this plan:

73% AV Level Silver Plan 87% AV Level Silver Plan Limited Cost Sharing Plan Variation Standard Silver Off Exchange Plan Standard Silver On Exchange Plan Zero Cost Sharing Plan Variation

More Access Connected Care Partners plans in CO

Colorado Access Choice EPO Colorado Option Bronze Colorado Access Choice EPO Bronze 8000 Colorado Access Choice EPO Bronze 7000 Rx Copay Colorado Access Choice EPO Silver 5000

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	$5.00

Specialist

Benefit	In-network
Specialist Visit	$30.00

Hospital

Benefit	In-network
Emergency Room Services	20.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	20.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	20.00% Coinsurance after deductible
Urgent Care Centers or Facilities	$30.00

Pharmacy

Benefit	In-network
Generic Drugs	No charge
Medical Service Drugs	20.00% Coinsurance after deductible
Non-Preferred Brand Drugs	$40.00
Non-Preferred Generic Drugs	$40.00
Preferred Brand Drugs	$10.00
Preventive Drugs	No charge
Specialty Drugs	$60.00

Mental Health

Benefit	In-network
Intensive Outpatient for Mental/Behavioral Health	20.00% Coinsurance after deductible
Intensive Outpatient for Substance Use Disorder	20.00% Coinsurance after deductible
Mental Health Wellness Visit	No charge
Mental/Behavioral Health Inpatient Services	20.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	20.00% Coinsurance after deductible
Mental/Behavioral Health Prenatal Care	$5.00
Office Visit - Mental/Behavioral Health	$5.00
Office Visit - Substance Use Disorder	$5.00
Partial Hospitalization for Mental/Behavioral Health	20.00% Coinsurance after deductible
Partial Hospitalization for Substance Use Disorder	20.00% Coinsurance after deductible
Postpartum Mental/Behavioral Health	$5.00
Postpartum Substance Use Disorder	$5.00
Residential Day Treatment for Mental/Behavioral Health	20.00% Coinsurance after deductible
Residential Day Treatment for Substance Use Disorder	20.00% Coinsurance after deductible
Substance Use Disorder Prenatal Care	$5.00
Telehealth Mental/Behavioral Health	$5.00
Telehealth Substance Use Disorder	$5.00

Other

Benefit	In-network
Abortion for Which Public Funding is Prohibited	No charge
Acupuncture	$30.00
Allergy Testing	20.00% Coinsurance after deductible
Applied Behavior Analysis Based Therapies	20.00% Coinsurance after deductible
Autism Spectrum Disorders - Assessment and Evaluation Services	20.00% Coinsurance after deductible
Bariatric Surgery	20.00% Coinsurance after deductible
Chemotherapy	20.00% Coinsurance after deductible
Chiropractic Care	$30.00
Delivery and All Inpatient Services for Maternity Care	20.00% Coinsurance after deductible
Diabetes Education	No charge
Diabetic Supplies	20.00% Coinsurance after deductible
Dialysis	20.00% Coinsurance after deductible
Durable Medical Equipment	20.00% Coinsurance after deductible
Emergency Transportation/Ambulance	20.00% Coinsurance after deductible
Eye Glasses for Children	No charge
Gender Affirming Care	20.00% Coinsurance after deductible
Habilitation Services	20.00% Coinsurance after deductible
Hearing Aids	20.00% Coinsurance after deductible
Home Health Care Services	20.00% Coinsurance after deductible
Hospice Services	20.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	20.00% Coinsurance after deductible
Infertility Treatment	20.00% Coinsurance after deductible
Infusion Therapy	20.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	20.00% Coinsurance after deductible
Inpatient Rehabilitation	20.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	$30.00
Nutritional Counseling	20.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)	$5.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	20.00% Coinsurance after deductible
Outpatient Rehabilitation Services	20.00% Coinsurance after deductible
Prenatal and Postnatal Care	$5.00
Private-Duty Nursing	20.00% Coinsurance after deductible
Prosthetic Devices	20.00% Coinsurance after deductible
Prosthetics: Legs and Arms	20.00%
Prosthetics: Recreational	20.00% Coinsurance after deductible
Radiation	20.00% Coinsurance after deductible
Reconstructive Surgery	20.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	$5.00
Rehabilitative Occupational Therapy	$5.00
Rehabilitative Physical Therapy	$5.00
Rehabilitative Speech Therapy	20.00% Coinsurance after deductible
Routine Eye Exam for Children	No charge
Skilled Nursing Facility	20.00% Coinsurance after deductible
Standalone Laboratory	$30.00
Substance Abuse Disorder Inpatient Services	20.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	20.00% Coinsurance after deductible
Telehealth PCP	$5.00
Telehealth Specialist	$30.00
Transplant	20.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	20.00% Coinsurance after deductible
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	20.00% Coinsurance after deductible

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