Robin Oak $3,500 HSA Silver

20173WI0130014
Silver
PPO

Robin Oak $3,500 HSA Silver is a Silver PPO plan by HealthPartners.

IMPORTANT: You are viewing the 2023 version of Robin Oak $3,500 HSA Silver 20173WI0130014. You can enroll in this plan if you qualify for special enrollment until the end of 2023.

Locations

Robin Oak $3,500 HSA Silver is offered in the following counties.

Plan Overview

This is a plan overview for 2023 version of Robin Oak $3,500 HSA Silver 20173WI0130014.
Insurer: HealthPartners
Network Type: PPO
Metal Type: Silver
HSA Eligible?: Yes
Plan ID: 20173WI0130014

Cost-Sharing Overview

Robin Oak $3,500 HSA Silver offers the following cost-sharing.

Notes:

  • Some plans have separate cost-sharing for medical and drugs, while other plans offer combined cost-sharing. The cost-sharing amounts above are combined medical and drug costs unless otherwise noted.
  • You are viewing the standard version of this plan. Your costs may be lower depending on your income. Use the “get a quote” button below to see your estimated premium and out-of-pocket costs after assistance.
Ready to sign up for Robin Oak $3,500 HSA Silver?

Click or call to enroll online, get a quote, or find out if you qualify for assistance.
Get Help from a licensed agent. 1-877-668-0904

Plan Features

Robin Oak $3,500 HSA Silver offers the following features and referral requirements.

Wellness Program: Yes
Disease Program: Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs
Notice Pregnancy: No
Referral Specialist: No
Specialist Requiring Referral:
Plan Exclusions:
Child Only Option?: Allows Adult and Child-Only

Network Details

The following network details will help you understand what Robin Oak $3,500 HSA Silver covers when you are out of the service area or out of the country.

Out of Country Coverage: Yes
Out of Country Coverage Description: Coverage for emergency services only
Out of Service Area Coverage: Yes
Out of Service Area Coverage Description: Out-of-Network benefits will be applied
National Network: No

Additional Benefits and Cost-Sharing

Robin Oak $3,500 HSA Silver includes the following benefits at the cost sharing rates listed below.

Free Preventive Services

There is no copayment or coinsurance for any of the following Robin Oak $3,500 HSA Silver preventive services. This is true even if you haven’t met your yearly deductible.

Please note, these services are free only when delivered by a doctor or other provider in your plan’s network.

Additional Resources

Below are additional resources for Robin Oak $3,500 HSA Silver including the Summary of Benefits & Coverage (SBC), plan brochure, formulary link, and a link to the website to pay your monthly premium after you enroll.

Summary of Benefits: Summary of Benefits Link
Plan Brochure: Plan Brochure Link
Formulary: Formulary Link
Premium Payment Website: Premium Payment Link
Ready to sign up for Robin Oak $3,500 HSA Silver?

Click or call to enroll online, get a quote, or find out if you qualify for assistance.
Get Help from a licensed agent. 1-877-668-0904

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