SILVER HSA 250/80 CSR PLAN
3000/80 – 87%
for Individuals and Families
MAJOR PLAN BENEFIT
Our Cost Share Reduction (CSR) plans lower the amount you pay for deductibles and coinsurance. 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 below a certain level. To see if you qualify for a CSR plan, visit www.healthcare.gov/lower-costs.
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 Health Care System and Bellin Health, both recognized for quality, to serve our members in 19 counties. Learn more about the Envision network featuring Aurora and Bellin!
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 covered medical bills for the rest of the year.
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.
Single – $250
Family – $500
Single – $2,250
Family – $4,500
20% of charges for in-network care
50% of charges for out-of-network care
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.
VIEW OTHER PLANS
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.