SimpliveraCoverage Companion

Navigator Silver 6000 (94)

PacificSource Health Plans · 2026 plan year

Silver
Ind. deductible
$200
Family deductible
$200
Ind. OOP max
$950
Family OOP max
$950

Other cost-sharing reduction variants for this plan:

73% AV Level Silver Plan87% AV Level Silver PlanLimited Cost Sharing Plan VariationStandard Silver Off Exchange PlanStandard Silver On Exchange PlanZero Cost Sharing Plan Variation

More PacificSource Health Plans plans in ID

Navigator Bronze HSA 8300Navigator Bronze HSA 6000Navigator Bronze HSA 10600Navigator Silver 3600Navigator Gold 2000

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$20.00

Hospital

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

Pharmacy

BenefitIn-network
Preferred Brand Drugs30.00% Coinsurance after deductible
Generic Drugs$15.00
Non-Preferred Brand Drugs30.00% Coinsurance after deductible
Specialty Drugs30.00% 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
Outpatient Rehabilitation Services30.00% Coinsurance after deductible
Accidental Dental30.00% Coinsurance after deductible
Acupuncture$5.00
Allergy Testing30.00% Coinsurance after deductible
Chemotherapy30.00% Coinsurance after deductible
Chiropractic Care$5.00
Cosmetic Surgery30.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care30.00% Coinsurance after deductible
Diabetes Education$5.00
Dialysis30.00% Coinsurance after deductible
Durable Medical Equipment30.00% Coinsurance after deductible
Emergency Transportation/Ambulance30.00% Coinsurance after deductible
Eye Glasses for Children30.00% Coinsurance after deductible
Habilitation Services30.00% Coinsurance after deductible
Home Health Care Services30.00% Coinsurance after deductible
Hospice Services30.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)30.00% Coinsurance after deductible
Infusion Therapy30.00% Coinsurance after deductible
Inpatient Physician and Surgical Services30.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services30.00% Coinsurance after deductible
Nutritional Counseling$5.00
Other Practitioner Office Visit (Nurse, Physician Assistant)$5.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)30.00% Coinsurance after deductible
Prenatal and Postnatal Care30.00% Coinsurance after deductible
Prosthetic Devices30.00% Coinsurance after deductible
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
Routine Foot Care30.00% Coinsurance after deductible
Skilled Nursing Facility30.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services30.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$5.00
TransplantNo Charge after deductible
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging30.00% Coinsurance after deductible

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