Oscar

Silver Elite Saver Plus

Prescription Drug Information

Inpatient Coverage

Emergency and Urgent Care

Links

Plan Overview

Medical Deductible	Individual: $0 Family: $0 Per Person: $0
Prescription Drug Deductible	Individual: $200 Family: $400 Per Person: $200
Medical Out-of-Pocket Maximum	Individual: $9,100 Family: $18,200 Per Person: $9,100
Drug Out-of-Pocket Maximum	Individual: Included in Medical Family: Included in Medical Per Person: Included in Medical

Office Visit

Primary Doctor	Standard: $60 Copay
Specialist	Standard: $100 Copay

Prescription Drug Information

Preferred Brand Drugs	Standard: $200 Copay after deductible
Non Preferred Brand Drugs	Standard: 50% Coinsurance after deductible
Generic Drugs	Standard: $3 Copay
Specialty Drugs	Standard: 50% Coinsurance after deductible

Inpatient Coverage

Hospital Services	Standard: 50% Coinsurance
Inpatient Services	Standard: 50% Coinsurance

Emergency and Urgent Care

Emergency Room

Standard: 50% Coinsurance