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Silver Value D 2018 by EmblemHealth

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Plan Information

Plan Name
Silver Value D 2018
Insurance Company
EmblemHealth

In Network Benefits

Office Co-pay
$35 ($0 first 3 visits)
Specialist Co-pay
$55
Hospital Co-pay
$0 after deductible
Emergency Room
$0 after deductible
Referrals Needed
Yes
Rx: Generic/Brand/High Brand
$10(deductible waived)/$0/$0 after deductible
In-Network Deductible (single/family)
$5,800/$11,600
In-Network Co-Insurance
0%
Max Out of Pocket (single/family)
$5,800/$11,600

Out Of Network Benefits

Deductible (single/family)
N/A
Co-Insurance
N/A
Out of Pocket Max (single/family)
N/A

Other Benefits

Vision/Dental
Vision and Dental
Renewal Date
Annual
HSA Eligible
No

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