Priority Health 382715520 – Mypriority Balanced Silver Trinity Health East Network 02
MyPriority Balanced Silver Trinity Health East Network
Summary
Plan Info & Network Details
Cost Sharing Details
Out of Pocket Maximum
Individual
$9000 per person
Family (Group)
$18000 per group
Deductible
Individual
$3400 per person
Family (Group)
$6800 per group
Coinsurance
Rate
30.00%
Out of Network Costs
Maximum
Individual
per person not applicable
Family (Group)
per group not applicable
Deductible
Individual
per person not applicable
Family (Group)
per group not applicable
Plan Features & Resources
The Plan Features & Resources section highlights important aspects of a health plan, such as specific options available to members, like the Child-Only Option, which enables enrollment for both adults and children separately. It also provides Additional Resources like downloadable brochures and links to the Premium Payment Website for managing payments. This section is designed to give users access to key features and helpful documents related to their plan.
Plan Features
Additional Resources
Covered Services
Covered Services outlines the different types of services and areas covered by your insurance plan. This includes the Dental-Only Plan, which limits coverage to dental services only, excluding other health-related services. Out-of-Country Coverage refers to services provided outside the country, generally covered at an out-of-network level. Out-of-Service Area Coverage applies to services received outside of the designated service area, also typically covered at the out-of-network rate. Lastly, IN Coverage is specific to a certain state (for example, Indiana), indicating that coverage applies to services or providers within that state. These categories help define the scope of your plan's coverage and the areas where services are covered.
Cost Sharing for Common Conditions
Cost sharing for common conditions generally refers to the portion of health care costs that a person is responsible for under their health insurance plan. This includes different components like the deductible, copayment, coinsurance, and limits for specific medical conditions or treatments. The deductible is the amount a patient must pay out-of-pocket before their insurance begins covering the cost of care. Copayments are fixed amounts that the insured pays for medical services or prescriptions, while coinsurance is the percentage of costs that the insured must pay after the deductible has been met. Limits define the maximum amount a person will have to pay for a specific treatment or condition under their health insurance plan. Understanding these elements helps individuals plan for potential out-of-pocket expenses when managing common health conditions, ensuring they know what to expect financially.
Having a Baby
Having Diabetes
Having a Simple Fracture
Plan Attributes
The Plan Attributes section provides an overview of the various features and details that define the structure of your insurance plan. This includes key attributes such as coverage limits, specific benefits, and services offered under the plan. It highlights important factors like the type of care covered, out-of-network options, and any additional resources available. Understanding these attributes will help you get a clear picture of your plan’s coverage and how it fits your healthcare needs.
Service Area Coverage
The Service Area Coverage section outlines the geographical areas where your health plan provides coverage. It includes details on which counties or ZIP codes are covered, helping you to understand the locations where you can access healthcare services under your plan. This coverage may vary depending on whether the area is serviced by an in-network provider. Each county or ZIP code listed shows whether it is covered by the plan and any specific limitations or conditions tied to the location. Ensure your area is covered for full access to the plan's benefits.
Hospitals That Accept This Insurance
The Hospitals That Accept This Insurance section provides a list of hospitals that are covered under the insurance plan you are currently reviewing. It includes important details such as the name of the hospital, the number of providers and beds available, the specialties offered, and the hospital's location. This section helps you find healthcare facilities that are included in your insurance network, ensuring that you receive the benefits your plan offers while seeking care. Data is available till 2025.
Providers That Accept This Insurance
The Providers That Accept This Insurance section lists healthcare professionals who accept the insurance plan you are viewing. It provides details about each provider, such as their name, specialty, years of experience, and ratings. This information helps you find doctors, dentists, and other medical professionals who are part of the insurance network, ensuring that you receive covered care within your insurance plan's terms. Data is available till 2025.