SoloCare Silver Copay 40232 Area 1
| Plan Type: | PPO |
| Plan Tier: | Silver |
| Individual Deductible | $0 |
| Family Deductible | $0 |
| Individual Out of Pocket Max | $8,550 |
| Family Out of Pocket Max | $17,100 |
| Primary Care Visit: | $50 |
| Specialist Visit: | $80 |
| Emergency Room: | $750 |
| Hospital - Physician: | No Charge |
| Hospital - Facility: | $500 Copay per Day |
| Link to Full SBC: | https://alliantplans.com/2021/solocare/40232_01.pdf |
| Plan Brochure: | https://alliantplans.com/2021/solocare-2021-brochure.pdf |
Other Coverage:
| Child Dental: | Yes |
| Adult Dental | No |
Prescription Drug Pricing:
| Generic Drugs: | $30 |
| Non-Preferred Brand Drugs: | $75 |
| Preferred Brand Drugs: | $60 |
| Specialty Drugs: | $250 |
| Summary of Benefits | https://magellan.adaptiverx.com/webSearch/index?key=cnhmbGV4LnBsYW4uUGxhblBkZlR5cGUtNTk5 |
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