Select Health
Signature Benchmark Silver 5900 Medical Deductible
Plan ID68781UT0200014
Plan year2027Sold on HealthCare.gov
Plan typeHMONo referral needed
Metal levelSilverNot HSA-eligible
Sold in4 countiesof 29 in Utah
Deductible$5,900$11,800 family
Out-of-pocket max$10,000$20,000 family
Primary care visit$25in network
Generic drugs$25per prescription
9,872 Utah doctors and facilities in this plan's network · Directory updated Nov 3, 2026 · Monthly premiums are not shown: they depend on age, county and income. NPI Profile does not sell insurance; HealthCare.gov lists premiums and handles enrollment.
Find a doctor in this plan
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What kind of doctor in ?
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Listed in Select Health's provider directory. Directories can be out of date, so call the office to confirm they take this plan.
What you pay with this plan
In-network costs for one person, from the CMS plan files for 2027. "After deductible" means you pay the full cost until you reach the $5,900 deductible.
Doctor visits
- Primary care visit
- $25
- Specialist visit
- $50
- Nurse practitioner or PA visit
- $25
- Preventive care and vaccines
- Free
- Urgent care
- $50
Prescription drugs
- Generic drugs
- $25
- Preferred brand drugs
- 25% after deductible
- Non-preferred brand drugs
- 50% after deductible
- Specialty drugs
- 50% after deductible
Tests and imaging
- Lab work
- $35
- X-rays
- $50
- MRI, CT and PET scans
- $350
Emergencies and hospital
- Emergency room
- $600 after deductible
- Ambulance
- 50% after deductible
- Hospital stay
- 50% after deductible
- Outpatient surgery (facility)
- 50% after deductible
Mental health
- Therapy and counseling visits
- $25
- Inpatient mental health care
- 50% after deductible
Pregnancy
- Prenatal and postnatal care
- $25
- Delivery and hospital stay
- 50% after deductible
Other care
- Physical and occupational therapyLimit: 30 days a year
- $50 after deductible
- Chiropractic care
- Not covered
- Eye exam for childrenLimit: 1 visit a year
- $50
- Glasses for childrenLimit: 1 item a year
- 50% after deductible
- Adult dental
- Not covered
$9,460Having a baby (CMS example)
$1,420Managing type 2 diabetes for a year
$2,500A simple fracture
Every service in the plan file (70)
| Service | You pay | Limits and notes |
|---|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered | |
| Accidental Dental | Not covered | |
| Acupuncture | Not covered | |
| Allergy Testing | $50 | |
| Autism Spectrum Disorders | 50% after deductible | |
| Bariatric Surgery | Not covered | |
| Basic Dental Care - Adult | Not covered | |
| Basic Dental Care - Child | Not covered | |
| Chemotherapy | 50% after deductible | |
| Chiropractic Care | Not covered | |
| Cosmetic Surgery | Not covered | |
| Delivery and All Inpatient Services for Maternity Care | 50% after deductible | |
| Dental Check-Up for Children | Not covered | |
| Diabetes Education | 50% after deductible | |
| Dialysis | 50% after deductible | |
| Durable Medical Equipment | 50% after deductible | Certain limitations and exclusions exist. Refer to the plan materials for more information. |
| Emergency Room Services | $600 after deductible | |
| Emergency Transportation/Ambulance | 50% after deductible | |
| Eye Glasses for Children | 50% after deductible | 1 item a year Frames are not covered |
| Gender Affirming Care | Not covered | |
| Generic Drugs | $25 | |
| Habilitation Services | $25 | 20 visits a year |
| Hearing Aids | Not covered | |
| Home Health Care Services | 50% after deductible | 30 visits a year |
| Hospice Services | 50% after deductible | 6 months every 3 years |
| Imaging (CT/PET Scans, MRIs) | $350 | |
| Infertility Treatment | Not covered | |
| Infusion Therapy | 50% after deductible | |
| Inherited Metabolic Disorder - PKU | $50 | |
| Inpatient Hospital Services (e.g., Hospital Stay) | 50% after deductible | |
| Inpatient Physician and Surgical Services | 50% after deductible | |
| Laboratory Outpatient and Professional Services | $35 | |
| Long-Term/Custodial Nursing Home Care | Not covered | |
| Major Dental Care - Adult | Not covered | |
| Major Dental Care - Child | Not covered | |
| Mental/Behavioral Health Inpatient Services | 50% after deductible | Certain limitations and exclusions exist. Refer to the plan materials for more information. |
| Mental/Behavioral Health Outpatient Services | $25 | Certain limitations and exclusions exist. Refer to the plan materials for more information. |
| Non-Preferred Brand Drugs | 50% after deductible | |
| Nutritional Counseling | Not covered | |
| Orthodontia - Adult | Not covered | |
| Orthodontia - Child | Not covered | |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $25 | |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 50% after deductible | |
| Outpatient Rehabilitation Services | $25 | 20 visits a year |
| Outpatient Surgery Physician/Surgical Services | 50% after deductible | |
| Preferred Brand Drugs | 25% after deductible | |
| Prenatal and Postnatal Care | $25 | |
| Preventive Care/Screening/Immunization | Free | |
| Primary Care Visit to Treat an Injury or Illness | $25 | |
| Private-Duty Nursing | Not covered | |
| Prosthetic Devices | Not covered | |
| Radiation | 50% after deductible | |
| Reconstructive Surgery | 50% after deductible | Covered only in limited circumstances |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $50 after deductible | 30 days a year |
| Rehabilitative Speech Therapy | $50 after deductible | 30 days a year |
| Routine Dental Services (Adult) | Not covered | |
| Routine Eye Exam (Adult) | Not covered | |
| Routine Eye Exam for Children | $50 | 1 visit a year |
| Routine Foot Care | Not covered | |
| Skilled Nursing Facility | 50% after deductible | 30 days a year |
| Specialist Visit | $50 | |
| Specialty Drugs | 50% after deductible | |
| Substance Abuse Disorder Inpatient Services | 50% after deductible | Certain limitations and exclusions exist. Refer to the plan materials for more information. |
| Substance Abuse Disorder Outpatient Services | $25 | Certain limitations and exclusions exist. Refer to the plan materials for more information. |
| Transplant | 50% after deductible | Covered only in limited circumstances |
| Treatment for Temporomandibular Joint Disorders | Not covered | |
| Urgent Care Centers or Facilities | $50 | |
| Weight Loss Programs | Not covered | |
| Well Baby Visits and Care | Free | |
| X-rays and Diagnostic Imaging | $50 |
How this plan works
HMO: You pick a primary care doctor in the network, and most specialists need a referral from them. Care outside the network is not covered, except emergencies.
- Referral for specialists
- Not required
- Coinsurance
- 50% after the deductible
- Works with an HSA
- No
- Network
- Select Signature IND Intermountain, University of Utah, Common Spirit, HCA (medical), Classic (dental) (UTN003)
- Sold in
- 4 Utah countiesDavis County, Salt Lake County, Utah County, Weber County
Summary of Benefits and Coverage (PDF) Plan brochure Covered drugs (formulary)
Other Select Health plans on the same network
The same doctors and hospitals, with different costs.
| Plan | Metal | Deductible | Out-of-pocket max |
|---|---|---|---|
| Signature Benchmark Gold HMO | Gold | $0 | $8,950 |
| Signature Benchmark Gold Standardized Plan HMO | Gold | $2,500 | $8,600 |
| Signature Benchmark Silver Standardized Plan HMO | Silver | $6,400 | $10,300 |
Questions about Signature Benchmark Silver 5900 Medical Deductible
Does Signature Benchmark Silver 5900 Medical Deductible cover my doctor?
Use "Find a doctor in this plan" on this page: choose the city, then the kind of doctor. The list shows providers Select Health lists in this plan's network for 2027. Directories can be out of date, so call the office to confirm before your visit.
What kind of plan is Signature Benchmark Silver 5900 Medical Deductible?
It is an HMO plan: you pick a primary care doctor in the network, and most specialists need a referral from them. Care outside the network is not covered, except emergencies. It is a Silver plan.
How much is a doctor visit with Signature Benchmark Silver 5900 Medical Deductible?
A primary care visit costs $25. A specialist visit costs $50. These are in-network costs for one person. "After deductible" means you pay the full cost until you reach the $5,900 deductible.
Where is Signature Benchmark Silver 5900 Medical Deductible sold?
It is sold to people who live in 4 Utah counties, through HealthCare.gov. The counties: Davis County, Salt Lake County, Utah County, Weber County. Select Health's directory can also list providers outside these counties, such as pharmacies and specialists, but the plan itself is only for people who live in its area.
Why is there no monthly premium on this page?
Premiums depend on your age, county, household size and income, and most people get a subsidy, so a single price would mislead. HealthCare.gov shows the price for your household.
About this data
NPI Profile is not an insurance company, agent or broker, and it does not sell insurance or enroll anyone in a plan. It is a free reference tool built on public files that CMS and insurers publish, to help you compare Marketplace plans and check whether your current or future doctor is in a plan's network. It is not affiliated with CMS, HealthCare.gov, any state exchange or any insurer. Confirm costs and networks with the insurer and the doctor's office, and enroll on HealthCare.gov.
| Source | What it provides here | Source date |
|---|---|---|
| CMS Marketplace public use files (Plan Attributes, Benefits and Cost Sharing, Service Area) | This plan's costs, covered services, coverage examples and the counties where it is sold | Plan year 2027 |
| Select Health's provider directory | The doctors and facilities listed in this plan's network. Only providers with an address in Utah are counted. | Updated November 3, 2026 |
| NPPES NPI registry | Provider names, practice addresses and primary specialties | Matched November 8, 2026 |
- Costs are for the standard version of the plan, for one person, in network. People who qualify for cost-sharing reductions pay less.
- Monthly premiums are not shown: they depend on age, county, household and income. HealthCare.gov lists them for your household.
- Confirm costs in the plan documents and with the insurer, and confirm with the doctor's office that they take this plan.
