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Deductible: The plan year dollar amount you pay before Copayments or Coinsurance are applied to covered services.
Out-of-Pocket Maximum: The plan year dollar maximum of your cost sharing including Deductibles, Copayments and Coinsurance, for covered services. After reaching this limit, the plan pays 100% of covered services for the rest of the plan year.
Coinsurance: The percentage of cost sharing you pay for specific types of covered services, after you meet your deductible.
Note: Plan eligibility depends on income level. Refer to your EOC and SBC for full benefit and coverage details. Preventive Services are provided at no cost.
* Florida Constant Care Silver 7 is only available in the following counties: Clay, Duval, Hillsborough, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, and Seminole
† Florida Constant Care Silver 5 is only available in the following counties: Broward and Miami-Dade.
Florida Constant Care Silver 5 is Molina’s first tiered benefit plan. With cost-sharing that depends on which tier a facility is in, tiered benefit plans help members make cost-effective choices.
Florida Constant Care Silver 5 facilities have two tiers: Choice Network for lower plan cost-sharing services and Select Network for higher plan cost-sharing services. Before receiving service, members can verify the providers in each tier by going online or calling a number on their ID Card.