Benefits & Coverage

Insurance Type
Individual Health Insurance (Obamacare)
Insurance Provider
Regence BlueCross BlueShield of Utah
Metal Level
Bronze
Plan Type
PPO
Deductible
$5000
Out-of-Pocket Maximum
$6250
Plan Highlights

Cost & Coverage

Estimated Monthly Base Rate
Estimated monthly premium starts at $130.78
Deductible
Individual: $5000
Family: $10000
In-Network Out-of-Pocket Limit
Individual: $6250
Family: $12500
What is included in the in-network out-of-pocket limit?
Deductible + Coinsurance
Is this plan Health Savings Account (HSA) eligible?
No
How can I find a doctor in this plan's network?
Plan Type
PPO

Health Services Options

Service
In Network
Out of Network
Primary care physician office visit
30% Coinsurance after deductible
50% Coinsurance after deductible
Specialist
30% Coinsurance after deductible
50% Coinsurance after deductible
Diagnostic Test (X-ray, blood work)
30% Coinsurance after deductible
50% Coinsurance after deductible
Outpatient Facility Fee
30% Coinsurance after deductible
50% Coinsurance after deductible
Outpatient Physician/Surgeon Fee
30% Coinsurance after deductible
50% Coinsurance after deductible
Hospital facility fee
30% Coinsurance after deductible
50% Coinsurance after deductible
Hospital physician/surgeon fee
30% Coinsurance after deductible
50% Coinsurance after deductible
Emergency Room
30% Coinsurance after deductible
30% Coinsurance after deductible

Drug Services

Generic Drugs
Coverage: 25% Coinsurance after deductible
Preferred Brand Drugs
Coverage: 35% Coinsurance after deductible
Specialty Drugs
Coverage: 40% Coinsurance after deductible

Mental Health or Substance Abuse Services

Service
In Network
Out of Network
Mental/behavioral health outpatient services
30% Coinsurance after deductible
50% Coinsurance after deductible
Mental/behavioral health inpatient services
30% Coinsurance after deductible
50% Coinsurance after deductible
Substance use disorder inpatient services
30% Coinsurance after deductible
50% Coinsurance after deductible
Substance use disorder outpatient services
30% Coinsurance after deductible
50% Coinsurance after deductible

Maternity Services

Service
In Network
Out of Network
Prenatal/postnatal care
30% Coinsurance after deductible
50% Coinsurance after deductible
Delivery and all inpatient services for maternity care
30% Coinsurance after deductible
50% Coinsurance after deductible

Coverage Options Summary

Included Benefits
  • Dental care adult
  • Dental check up children
  • Durable medical equipment
  • Emergency Transportation
  • Eye exam adult
  • Eye glasses children
  • Habilitation
  • Home health care
  • Hospice
  • Imaging (CT/PET scans, MRIs)
  • Inpatient rehabilitation
  • Non-preferred brand drugs
  • Skilled nursing care
  • Other practitioner office visit
  • Outpatient rehabilitation
  • Preventive care, screening, immunization
  • Routine eye exam children
  • Urgent Care
Excluded Benefits
  • Acupuncture
  • Bariatric surgery
  • Chiropractic
  • Cosmetic surgery
  • Hearing Aid
  • Infertility treatment
  • Long Term Care
  • Private duty nursing
  • Routine foot care
  • Routine hearing tests
  • Weight loss program
Limited Benefits
  • Non-emergency care outside U.S.

What To Know

  • This is an ACA (Obamacare) compliant health plan.
  • This plan is not available on healthcare.gov or other Health Exchanges

Physician Directory

List of doctors that accepts Regence Direct Bronze HSA - Preferred FocalPoint Network without options Obamacare Plan in Utah

/
BOOTH, EDGAR
3460 PIONEER PKWY
WEST VALLEY CITY, UT 84120
EDSON, D
3460 PIONEER PKWY
WEST VALLEY CITY, UT 84120
MUSSO, LOUIS
3336 S 4155 W
WEST VALLEY CITY, UT 84120
GEURTS, GERALD
3725 W 4100 S
WEST VALLEY CITY, UT 84120
TRAN, TAN
3336 PIONEER PKWY
WEST VALLEY CITY, UT 84120
OLIVER, STEVE
3725 W 4100 S
WEST VALLEY CITY, UT 84120
FEIL, MATTHEW
3460 PIONEER PKWY
WEST VALLEY CITY, UT 84120
GRANGE, TIMOTHY
4052 PIONEER PKWY
SALT LAKE CITY, UT 84120
KOLBER, SHARON
3460 PIONEER PKWY
WEST VALLEY CITY, UT 84120
COLE, DAVID
3460 PIONEER PKWY
WEST VALLEY CITY, UT 84120
LARSEN, BRENT
3460 PIONEER PKWY
WEST VALLEY CITY, UT 84120
PUTNAM, CATHEY
3460 PIONEER PKWY
WEST VALLEY CITY, UT 84120
NICHOLLS, CHAD
3460 PIONEER PKWY
WEST VALLEY CITY, UT 84120
PERRY, ROGER
3460 PIONEER PKWY
WEST VALLEY CITY, UT 84120
WEBER, QUINN
3460 PIONEER PKWY
WEST VALLEY CITY, UT 84120
GOODMAN, GORDON
3336 S 4155 W STE 306
WEST VALLEY CITY, UT 84120
PALMA, LOMBARDO
3540 S 4000 W
WEST VALLEY CITY, UT 84120
YOUNG, JON
3336 PIONEER PKWY
WEST VALLEY CITY, UT 84120
ALDOUS, EDWIN
3725 W 4100 SOUTH
WEST VALLEY CITY, UT 84120
IRVINE, BRUCE
3725 W 4100 SOUTH
WEST VALLEY CITY, UT 84120
EYRE, ALYSON
3725 W 4100 SOUTH
WEST VALLEY CITY, UT 84120
BANE, J
3725 W 4100 SOUTH
WEST VALLEY CITY, UT 84120
HOLLINGSED, TIMOTHY
3725 W 4100 S
WEST VALLEY CITY, UT 84120
DINGER, STEVEN
3725 W 4100 S
WEST VALLEY CITY, UT 84120
SMITH, JOHN
3336 PIONEER PKWY
SALT LAKE CITY, UT 84120
Details
EDGAR BOOTH, MD
Phone Number
(801) 964-3100
Office Locations
3460 PIONEER PKWY
WEST VALLEY CITY, UT 84120
3460 PIONEER PKWY WEST VALLEY CITY UT, 84120

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