AV Calculator Output Number
0.879343125802828
Begin Primary Care Deductible Coinsurance After Number Of Copays
0
Drug EHB Deductible, In Network (Tier 1), Default Coinsurance
30.00%
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
20.00%
SBC Scenario, Having a Baby, Coinsurance
$2,200
SBC Scenario, Having a Baby, Copayment
$0
SBC Scenario, Having a Baby, Deductible
$750
SBC Scenario, Having Diabetes, Coinsurance
$30
SBC Scenario, Having Diabetes, Copayment
$1,200
SBC Scenario, Having Diabetes, Deductible
$750
SBC Scenario, Treatment of a Simple Fracture, Coinsurance
$300
SBC Scenario, Treatment of a Simple Fracture, Copayment
$100
SBC Scenario, Treatment of a Simple Fracture, Deductible
$750
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
$5800 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person
$2900 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual
$2,900
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