Moda Select 2016 PlansCompared |
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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 |
32 |
$341 |
$300 |
$284 |
$267 |
$223 |
$211 |
33 |
$346 |
$304 |
$287 |
$270 |
$236 |
$214 |
34 |
$350 |
$308 |
$291 |
$274 |
$239 |
$217 |
35 |
$353 |
$310 |
$293 |
$276 |
$240 |
$218 |
36 |
$355 |
$312 |
$295 |
$278 |
$242 |
$219 |
37 |
$357 |
$314 |
$297 |
$279 |
$244 |
$221 |
38 |
$360 |
$316 |
$299 |
$281 |
$245 |
$222 |
39 |
$364 |
$320 |
$303 |
$285 |
$248 |
$225 |
40 |
$369 |
$324 |
$307 |
$288 |
$251 |
$228 |
41 |
$376 |
$330 |
$312 |
$294 |
$256 |
$232 |
42 |
$382 |
$336 |
$318 |
$299 |
$261 |
$236 |
43 |
$392 |
$344 |
$326 |
$306 |
$267 |
$242 |
44 |
$403 |
$354 |
$335 |
$315 |
$275 |
$249 |
45 |
$417 |
$366 |
$347 |
$326 |
$284 |
$258 |
46 |
$433 |
$380 |
$360 |
$339 |
$295 |
$268 |
47 |
$451 |
$396 |
$375 |
$353 |
$308 |
$279 |
48 |
$472 |
$415 |
$392 |
$369 |
$322 |
$292 |
49 |
$492 |
$433 |
$409 |
$385 |
$336 |
$304 |
50 |
$515 |
$453 |
$429 |
$403 |
$351 |
$319 |
51 |
$538 |
$473 |
$448 |
$421 |
$367 |
$333 |
52 |
$563 |
$495 |
$468 |
$441 |
$384 |
$348 |
53 |
$589 |
$517 |
$490 |
$460 |
$401 |
$364 |
54 |
$616 |
$542 |
$512 |
$482 |
$420 |
$381 |
55 |
$644 |
$566 |
$535 |
$503 |
$439 |
$398 |
56 |
$673 |
$592 |
$560 |
$527 |
$459 |
$416 |
57 |
$703 |
$618 |
$585 |
$550 |
$480 |
$435 |
58 |
$735 |
$646 |
$611 |
$575 |
$501 |
$454 |
59 |
$751 |
$660 |
$625 |
$588 |
$512 |
$464 |
60 |
$783 |
$688 |
$651 |
$613 |
$534 |
$484 |
61 |
$811 |
$713 |
$674 |
$634 |
$553 |
$501 |
62 |
$829 |
$729 |
$689 |
$648 |
$565 |
$512 |
63 |
$852 |
$749 |
$708 |
$666 |
$581 |
$527 |
64 |
$866 |
$761 |
$720 |
$677 |
$590 |
$534 |