AV Calculator Output Number
0.879180239
Begin Primary Care Deductible Coinsurance After Number Of Copays
0
Inpatient Copayment Maximum Days
0
Medical Drug Deductibles Integrated
Yes
Medical Drug Maximum Out of Pocket Integrated
Yes
SBC Scenario, Having a Baby, Coinsurance
$2,300
SBC Scenario, Having a Baby, Copayment
$20
SBC Scenario, Having a Baby, Deductible
$600
SBC Scenario, Having Diabetes, Coinsurance
$200
SBC Scenario, Having Diabetes, Copayment
$600
SBC Scenario, Having Diabetes, Deductible
$600
SBC Scenario, Treatment of a Simple Fracture, Coinsurance
$400
SBC Scenario, Treatment of a Simple Fracture, Copayment
$200
SBC Scenario, Treatment of a Simple Fracture, Deductible
$600
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group
per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person
per person not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual
Not Applicable
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance
30.00%
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group
$5900 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person
$2950 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual
$2,950
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group
$23600 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person
$11800 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual
$11,800