Member Services: 877-514-2442

SILVER 200/80 CSR PLAN
2400/80 – 87%

for Individuals and Families

MAJOR PLAN BENEFIT

Our Cost Share Reduction (CSR) plans lower the amount you pay for deductibles, coinsurance and co-payments. You also have a lower out-of-pocket maximum. You can get these savings in plans in the Silver plan category if your income is at or below a certain level. Visit www.healthcare.gov/lower-costs to see if you qualify for a CSR plan.

HEALTH PERKS

PREVENTIVE CARE
Even if you haven’t met your yearly deductible, you can still get the free, in-network preventive care recommended under the Affordable Care Act.  Preventive care includes certain screenings, vaccines, and annual physicals when performed by an in-network provider.

CGHC DOCTOR LINE
The CGHC Doctor Line, powered by Teladoc, Inc is a new service that allows you to receive treatment from a Board Certified, licensed physician via video, mobile application, or telephone. The first three consultations are free for most CGHC members except for those in a Health Savings Account (HSA) compatible plan, due to federal HSA rules. If you have satisfied your three visits, or you are in an HSA plan, you will pay $40 or your PCP co-pay, whichever is less. Learn more about the CGHC Doctor Line!

COVERAGE WHERE YOU NEED IT

YOUR NETWORK OF PROVIDERS
We are proud to partner with Aurora Healthcare System and Bellin Health, both recognized for quality, to serve our members in 19 counties. Learn more about the Envision Aurora/Bellin network!

COVERAGE FROM ANY PHARMACY
This plan does not limit you to certain in-network pharmacy providers.

EMERGENCY CARE, ANYWHERE, IS IN-NETWORK
Services that meet the definition of emergency are covered as in network even when care is delivered in a non-network ER.

GET THE MOST FROM YOUR PLAN

Most of your healthcare costs are paid after you hit your deductible and your out-of-pocket maximum. Once you’ve met your deductible during the plan year, CGHC will pay 80% of all your in-network health bills until you reach your Out-of-Pocket Maximum of $2,250 (more for families and out-of-network providers). At that point, we’ll cover 100% of your in-network qualified medical bills for the rest of the year.

PLAN FACTS

YOU WILL PAY

You will pay the discounted price for covered medical services until your deductible is met. After your deductible is met, you will pay 20% for in-network care.

IN-NETWORK DEDUCTIBLE

Single – $200
Family – $400

OUT-OF-POCKET MAX.

Single – $2,250
Family – $4,500
(In-Network)

CO-INSURANCE

$0 for in-network care
30% of charges for out-of-network care

PRESCRIPTION DRUGS

You will pay the discounted price of covered medications until your deductible is met, then you will pay 20% of the cost until you reach your out-of-pocket maximum.

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Download a copy of your plan’s Summary of Benefits and Coverage

Common Ground Healthcare Cooperative does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations.

This page provides summary information.  Please refer to the certificate of coverage and schedule of benefits for a complete listing of benefits and terms of coverage.  A list of exclusions and limitations can be found here.