AV Calculator Output Number
0.8780761485206761
Begin Primary Care Deductible Coinsurance After Number Of Copays
0
Drug EHB Deductible, In Network (Tier 1), Default Coinsurance
50.00%
Inpatient Copayment Maximum Days
0
Medical Drug Deductibles Integrated
No
Medical Drug Maximum Out of Pocket Integrated
Yes
Medical EHB Deductible, In Network (Tier 1), Default Coinsurance
10.00%
SBC Scenario, Having a Baby, Coinsurance
$1,100
SBC Scenario, Having a Baby, Copayment
$10
SBC Scenario, Having a Baby, Deductible
$1,175
SBC Scenario, Having Diabetes, Coinsurance
$0
SBC Scenario, Having Diabetes, Copayment
$600
SBC Scenario, Having Diabetes, Deductible
$900
SBC Scenario, Treatment of a Simple Fracture, Coinsurance
$90
SBC Scenario, Treatment of a Simple Fracture, Copayment
$200
SBC Scenario, Treatment of a Simple Fracture, Deductible
$1,175
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
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group
$6700 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person
$3350 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual
$3,350
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group
per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person
per person not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual
Not Applicable