PPO plans have in-network and out-of-network coverage for most services. The out-of-network annual deductible and out-of-pocket maximum are double the in-network amount. The amounts listed below apply for in-network services only.
| Simply Blue Routine Care Plan options | Silver $2,000 | Silver $3,000 |
|---|---|---|
| Annual deductible (individual / family) | $2,000 / $4,000 | $3,000 / $6,000 |
| Coinsurance Percentage | 30% | 20% |
| Embedded Coinsurance Maximum | N/A | N/A |
| Out-of-pocket maximum (individual / family) | $7,350 / $14,700 | $6,600 / $13,200 |
| Office visit copays | $30 | $30 |
| Pharmacy copays | $10 | $10 |
Find more details about this plan in the Simply Blue Group Benefits Certificate (PDF).
Certificates are legal documents that describe the benefits of a health insurance plan. Your plan might have different benefits and limitations than those listed in this document.