![Molina Healthcare (1) Molina Healthcare Silver 2 Plan](https://www.ilhealthagents.com/wp-content/uploads/2023/07/Molina-Healthcare-1.png)
Silver Plan 2 Cost Sharing Reduction | Silver Plan 2 Cost Sharing Reduction | Silver Plan 2 Cost Sharing Reduction | Silver Plan | |
---|---|---|---|---|
Services | CSR 100 | CSR 150 | CSR 200 | 2/250 |
Value Basics | ||||
Teladoc Virtual Care Visits 24/7/365 | FREE | FREE | FREE | FREE |
Annual Wellness Visit – Adults | FREE | FREE | FREE | FREE |
Routine Preventive Screenings – Children & Adults | FREE | FREE | FREE | FREE |
Routine Vision Exams & eyewear for Children (0-18) | FREE | FREE | FREE | FREE |
Preventive Prescription Drugs | FREE | FREE | FREE | FREE |
24 Hour Nurse Line | FREE | FREE | FREE | FREE |
Urgent Care at Same Cost as Primary Physician Visit | YES | YES | YES | YES |
Plan Options with Adult Vision Services | Not Available | Not Available | Not Available | Not Available |
Benefit & Cost Share Highlights | ||||
Deductible (Ind/Fam) | $0 | $0 | $3,450 Comb. Med/Rx | $5,200 Comb. Med/Rx |
Out-of-Pocket Max (Ind/Fam) | $1,200/$2,400 | $2,850/$5,700 | $6,700 / $13,400 | $8,150 / $16,300 |
Drug Deductible (Ind/Fam) | $0/$0 | $0/$0 | Comb. w/ med | Comb. w/ med |
Emergency Room Services | 25% | 40% | 40% after ded | 40% after ded |
Hospital / Facility Services | ||||
Inpatient Hospital | $300/day (max 2 copays) | $575/day (max 2 copays) | $900/day (max 2 copays) | $1,350/day (max 2 copays) |
Skilled Nursing Facility Services | $300/day | $575/day | $900/day | $1,350/day |
Hospital Physician Services | $10 | $30 | $40 | $65 |
Outpatient Surgery Services | 25% | 40% | 40% after ded | 40% after ded |
Outpatient Services | ||||
Primary & Urgent Care Services | $0 | $10 | $20 | $30 |
Specialist Services | $10 | $30 | $40 | $65 |
Mental/Behavioral Health Services | $0 | $10 | $20 | $30 |
Imaging & Specialized Radiology | 25% | 40% | 40% after ded | 40% after ded |
Rehabilitative Services -ST, OT, PT | 25% | 40% | 40% after ded | 40% after ded |
Routine Laboratory Services | $0 | $30 | $30 | $40 |
Routine X-Ray & Diagnostic Services | 25% | 40% | 40% after ded | 40% after ded |
Prescription Drugs | ||||
Tier 1 – Preferred Generic Drugs | $0 | $10 | $20 | $25 |
Tier 2 – Preferred Brand Drugs | $15 | $40 | $60 | $65 |
Tier 3 – Non-Pref Brand & Generic Drugs | 25% | 40% | 40% after ded | 50% after ded |
Tier 4 – Specialty Drugs | 25% | 40% | 40% after ded | 50% after ded |
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