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SilverHMO

Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx

Antidote Health Plan of Arizona, Inc.

Starting at

$498

/month before subsidy

Key facts

Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx is a 2026 Silver HMO health insurance plan from Antidote Health Plan of Arizona, Inc., sold on the ACA Marketplace in Arizona under plan ID 68445AZ0600020. The monthly premium starts at $498 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $7,500 ($15,000 for a family), and the individual out-of-pocket maximum is $10,600 ($21,200 for a family). After the deductible, coinsurance is 40% for covered in-network care. The plan is not HSA-eligible.

Plan ID
68445AZ0600020
Plan year
2026
State
Arizona
Metal level
Silver
Plan type
HMO
HSA-eligible
No

Individual Deductible

$7,500

Family: $15,000

Out-of-Pocket Max

$10,600

Family: $21,200

Coinsurance

40%

You pay after deductible

Network Type

HMO

AZN001

Cost Sharing
What you pay for common services (after deductible unless noted)

Medical Services

Primary Care Visit$0.00
Specialist Visit$30.00
Urgent Care40.00% Coinsurance after deductible
Emergency Room40.00% Coinsurance after deductible

Prescription Drugs

Generic Drugs$15.00
Brand Name Drugs40.00% Coinsurance after deductible
Specialty Drugs40.00% Coinsurance after deductible
What you'd typically pay
Standardized coverage examples from this plan's official Summary of Benefits & Coverage — your estimated out-of-pocket cost in three common situations (in-network).

Having a baby

Normal delivery

$8,370

your estimated cost

Deductible
$6,500
Copays
$10
Coinsurance
$1,800

Managing type 2 diabetes

A year of routine care

$1,720

your estimated cost

Deductible
$900
Copays
$800
Coinsurance
$0

A simple fracture

ER visit + follow-up

$2,600

your estimated cost

Deductible
$2,500
Copays
$100
Coinsurance
$0
Is your medication or doctor covered?
Check this plan against your prescriptions and providers, using live data from the federal Marketplace (CMS). Always confirm with the insurer before enrolling.
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Official Plan Documents
Published by Antidote Health Plan of Arizona, Inc.. These are the authoritative source for coverage details.
Summary of Benefits & Coverage (SBC)Standardized cost & coverage summaryPlan BrochureFull plan details from the insurerDrug FormularyCovered prescriptions & drug tiers
Who This Plan Is Best For

This Silver HMO plan offers a balanced approach between monthly premiums and out-of-pocket costs, making it a popular choice for many families.

Consider this plan if you:

  • Visit the doctor a few times per year
  • Take regular prescription medications
  • Want moderate protection against high medical bills
  • May qualify for Cost-Sharing Reductions (CSR) to lower deductibles

This summary is generated based on plan attributes for educational purposes only.

Worst-Case Monthly Cost
What you'd pay if you hit your out-of-pocket maximum

If you max out this year

$1,381/month

Annual Premium

$5,976

OOP Maximum

$10,600

💡 What this means:

With a $7,500 deductible, you pay 100% of costs until you've spent that much. After that, you pay 40% (coinsurance) until you hit $10,600 total. Then insurance covers everything else for the year.

More plans from Antidote Health Plan of Arizona, Inc. in Arizona

View all Marketplace plans in Arizona

Frequently asked questions about Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx

How much does Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx cost per month?

Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx from Antidote Health Plan of Arizona, Inc. starts at $498 per month before any subsidy in Arizona. Most Marketplace enrollees qualify for a premium tax credit that lowers what they actually pay — estimate your subsidy to see your net premium.

What is the deductible for Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx?

The individual medical deductible is $7,500, and the family deductible is $15,000. You pay for covered care out of pocket until you meet the deductible, after which the plan shares costs with you.

What is the out-of-pocket maximum for Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx?

The most you would pay in a year for covered in-network care is $10,600 for an individual and $21,200 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx HSA-eligible?

No. Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx is not classified as an HSA-eligible high-deductible health plan, so it cannot be paired with a Health Savings Account.

What type of network does Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx use?

Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx is a HMO plan. HMO plans generally require you to use in-network providers and to get a referral to see a specialist, in exchange for lower costs.

Understand what you'd actually pay

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Important Notice

Plan details and costs shown are estimates for educational purposes only. Actual costs, coverage, and availability may vary. Always verify plan details and enroll through official channels at HealthCare.gov or your state marketplace.