|  | |
| Plan | Silver Full PPO Savings 2300/30% OffEx | Silver70 HSA (shop) |
| Metal | Silver | Silver |
| Network | Full PPO Network | Full PPO Network |
| Deductible | $2300 or $2800/$4600 family | $2300 or $3200/$4600 family |
| Coinsurance | 70% coverage for most services | 70% coverage for most services |
| Out of Pocket Mzx | $7900//$15,800 family | $7900//$15,800 family |
| Ambulance | 70% coverage after ded | 70% coverage after ded |
| Chiropractor | 70% coverage after ded (20 visits max) | 70% coverage after ded (20 visits max) |
| Durable Med Equip | 50% coverage after ded | 50% coverage after ded |
| Emergency Room | 70% coverage after ded | 70% coverage after ded |
| Hospital | 70% coverage after ded | 70% coverage after ded |
| Infertility | Optional | Optional |
| Lab & X-Ray | 70% coverage after ded | 70% coverage after ded |
| Office Visit | 70% coverage after ded | 70% coverage after ded |
| Specialist | 70% coverage after ded | 70% coverage after ded |
| Outpatient Surgery | 70% coverage after ded | 70% coverage after ded |
| Physical Therapy | 70% coverage after ded | 70% coverage after ded |
| Inpatient Psych | 70% coverage after ded | 70% coverage after ded |
| Outpatient Psych | 70% coverage after ded | 70% coverage after ded |
| Rx Tier 1 | $25 copayment after ded | $25 copayment after ded |
| Rx Tier 2 | $75 copayment after ded | $75 copayment after ded |
| Rx Tier 3 | $100 copay (after ded) | $100 copay (after ded) |
| Rx Tier 4 | 70% coverage up to $250 per Rx after ded | 70% coverage up to $250 per Rx after ded |
| Links | Brochure Formulary Providers | Brochure Formulary Providers |
| Cindy Garvey | 1220.39 | 1220.39 |
| Pete Maravich | 1045.51 | 1045.51 |
| Total | 2265.90 | 2265.90 |