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Standard Silver 300 by CDPHP

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Plan Information

Plan Name
Standard Silver 300
Insurance Company
CDPHP

In Network Benefits

Office Co-pay
$30 after deductible
Specialist Co-pay
$50 after deductible
Hospital Co-pay
$1,500 after deductible
Emergency Room
$250 after deductible
Referrals Needed
No
Rx: Generic/Brand/High Brand
$10/$35/$70
In-Network Co-Insurance
0%
Max Out of Pocket (single/family)
$6,750/$13,500

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 Only
Renewal Date
Annual
HSA Eligible
No

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