Medica with CHI Health Bronze HSA Plus Plan Details for 2020- HealthPocket

Medica with CHI Health Bronze HSA Plus

$443.06/mo

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Zip Code68104
Applicant2/23/1985 Male

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameMedica with CHI Health Bronze HSA Plus
Plan IDqhp-20305NE0020023
Plan Year2019
Insurance ProviderMedica
Metal LevelExpanded Bronze
Plan TypePPO
Deductible$2,600
Out-of-Pocket Maximum$6,650
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness40% Coinsurance after deductible
Specialist Visit40% Coinsurance after deductible
Deductible - Family$5200
Out-of-Pocket Maximum - Family$13300

Prescription drug coverage

Generic Drugs40% Coinsurance after deductible
Preferred Brand Drugs40% Coinsurance after deductible
Non-Preferred Brand Drugs40% Coinsurance after deductible
Specialty Drugs30% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttps://www.medica.com/uninet

Hospital services

Emergency Room Services40% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)40% Coinsurance after deductible
Inpatient Physician and Surgical Services40% Coinsurance after deductible
PremiumPlan NameDeductible
from $556
Gold 1
$2,700.00Select
from $712
Gold 3
$2,700.00Select
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  • Phone Number
    (402) 558-8100
  • Office Locations
    6069 Maple St
    Omaha, NE 68104
6069 Maple St Omaha NE, 68104

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).