Health Plan-Providence - Insurance Partners NW

Moda Select 2016 PlansCompared
COMPANY	Moda	Moda	Moda	Moda	Moda	Moda
Plan	BeProtected	BePrepared	StandardSilver	Be SupportedCCN	Standard Bronze	BeLively
MetalTier	Gold	Silver	Silver	Silver	Bronze (HASEligible)	Bronze
Deductible	$1,000	$1,550	$2,500	$2,500	$5,000	$5,500
Co-insurance	15%	30%	30%	35%	0%	40%
Maximum Out ofPocket (InNetwork)	$5,500	$6,850	$6,850	$6,500	$6,350	$6,850
PCP/Spec.copay	$15/$15	$30/$30	$35/$70	$30/$60	ded	$80
Urgent Carevisit	$15	$30	$90	$30	ded	$100
AlternativeCare	$15/$1000max	$30 visit/$1000max	na	na	na	40%
PrescriptionDrug	$2/$10/40%/50%	$2/$20/40%/50%	$15/$15/$50/50%	$2/$10/40%/50%	ded	$2/$10/ded/ded
Mental Healthvisit	$15	$30	$35	$30	ded	$80
Network	Beacon	Beacon	Beacon	CCN	Beacon	RoseCity
Non-Smoker, area 1rates	Monthly	Monthly	Monthly	Monthly	Monthly	Monthly
20 &Under	$183	$161	$152	$143	$125	$113
21	$289	$254	$240	$226	$197	$178
22	$289	$254	$240	$226	$197	$178
23	$289	$254	$240	$226	$197	$178
24	$289	$254	$240	$226	$197	$178
25	$290	$255	$241	$227	$198	$179
26	$296	$260	$246	$231	$201	$183
27	$302	$266	$251	$237	$206	$187
28	$314	$276	$261	$245	$214	$194
29	$323	$284	$269	$253	$220	$200
30	$328	$288	$272	$256	$223	$202
31	$334	$294	$278	$262	$228	$207