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Silver Plans

We offer three levels of plans for individuals and families. Each plan gives members access to world-class care from the Memorial Hermann Health System and the Memorial Hermann Physician Network, in which nearly 4,000 doctors practice.

Our 2017 silver plans offer the same core benefits with varying premium, coinsurance and copay costs, detailed in the chart below. Across the health insurance marketplace, most silver plans cover approximately 70 percent of your health care costs, while you pay approximately 30 percent.

Details for our 2017 silver plans are listed below. Details of our 2016 plans are listed below. Additional information is available via our Brochure.

For more information on 2016 plans, click here.

 4500
PPO
2850 H.S.A.
PPO
4500
HMO
Deductible$4,450$2,850$4,500
Family Deductible$9,000$5,700$9,000
Out-of-Pocket Maximum (Individual)$7,150$6,550$7,150
Out-of-Pocket Maximum (Family)$14,300$13,100$14,300
Member Coinsurance30%15%30%
PCP$3015% coinsurance
after deductible
$30
Specialist$7515% coinsurance
after deductible
$75
Telemedicine/TelehealthNo charge$40 applies to deductibleNo charge
Urgent Care$7515% coinsurance
after deductible
$80
Emergency Room$50015% coinsurance
after deductible
$500
Hearing & Speech Exams$7015% coinsurance
after deductible
$70
Independent & Outpatient Lab/Pathology30% coinsurance
after deductible
15% coinsurance
after deductible
30% coinsurance
after deductible
Radiology/X-rays30% coinsurance
after deductible
15% coinsurance
after deductible
30% coinsurance
after deductible
MRI/Scans/Nuclear Medicine30% coinsurance
after deductible
15% coinsurance
after deductible
30% coinsurance
after deductible
Inpatient Hospital30% coinsurance
after deductible
15% coinsurance
after deductible
30% coinsurance
after deductible
PT/OT/Chiro30% coinsurance
after deductible
15% coinsurance
after deductible
30% coinsurance
after deductible
Retail Generic Rx$4$4 after deductible$4
Retail Brand Rx$50$50 after deductible$50
Retail Non-Formulary Brand Rx$100$100 after deductible$100
Retail Specialty Rx50% coinsurance
after deductible
50% coinsurance
after deductible
50% coinsurance
after deductible

*The following notice is required upon enrollment if selecting an HMO Consumer Choice Health Benefit Plan you have the option to choose this Consumer Choice of Benefits Health Maintenance Organization health care plan that, either in whole or in part, does not provide state-mandated health benefits normally required in evidences of coverage in Texas. This standard health benefit plan may provide a more affordable health plan for you although, at the same time, it may provide you with fewer health plan benefits than those normally included as state-mandated health benefits in Texas. If you choose this standard health benefit plan, please consult with your insurance agent to discover which state-mandated health benefits are excluded in this evidence of coverage.

Rates are valid from 1/1/2017 – 12/31/2017

HMO Service Area: Harris, Fort Bend and Montgomery counties.

PPO Service Area: Harris, Fort Bend, Montgomery, Brazoria, Galveston, Walker and Wharton counties.

For individuals, find the rate that matches your age for the plan you’re interested in.

For families, find the rate that matches the age for all members of your family and add them together. If you have more than three (3) children, only add the rate for the three (3) oldest up to age 26.

The PPO is a Limited Hospital Care Network.


Gold Plans >