2019 Molina Choice Bronze Plan Details - HealthPocket

Molina Choice Bronze

$231.05/mo

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Zip Code79936
Applicant1/18/1984 Male
Coverage Start1/19/2019
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameMolina Choice Bronze
Plan IDqhp-45786TX0020003
Plan Year2019
Insurance ProviderMolina Healthcare
Metal LevelExpanded Bronze
Plan TypeHMO
Deductible$6,400
Out-of-Pocket Maximum$7,900
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$35 Copay
Specialist Visit$80 Copay
Laboratory Outpatient and Professional ServicesNot Applicable
X-rays and Diagnostic ImagingNot Applicable
Deductible - Family$12800
Out-of-Pocket Maximum - Family$15800

Prescription drug coverage

Generic Drugs$20 Copay
Preferred Brand Drugs40% Coinsurance after deductible
Non-Preferred Brand Drugs50% Coinsurance after deductible
Specialty Drugs50% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLComing Soon

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

Maternity

Prenatal and Postnatal CareNot Applicable

Mental Health

Mental/Behavioral Health Outpatient ServicesNot Applicable
Mental/Behavioral Health Inpatient Services40.00% Coinsurance after deductible

Vision Coverage

Routine Eye Exam for ChildrenNot Applicable
Eye Glasses for ChildrenNot Applicable

Exclusions and Limitations

More Included BenefitsChiropractic Care
Durable Medical Equipment
Hearing Aids
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Rehabilitative Speech Therapy
Rehabilitative Occupational and Rehabilitative Physical Therapy
Well Baby Visits and Care
Transplant
Accidental Dental
Dialysis
Allergy Testing
Chemotherapy
Radiation
Diabetes Education
Prosthetic Devices
Infusion Therapy
Treatment for Temporomandibular Joint Disorders
Reconstructive Surgery
Habilittion - Autism
Brain Injury
Autism Spectrum Disorders
Other Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
More Excluded BenefitsRoutine Foot Care
Acupuncture
Weight Loss Programs
Dental Check-Up for Children
Abortion for Which Public Funding is Prohibited
Nutritional Counseling
Infertility Treatment
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Bariatric Surgery
Cosmetic Surgery
PremiumPlan NameDeductible
from $294
Community Health Choice HMO Bronze 003
$6,500.00Select
from $346
Ambetter Balanced Care 2 (2019)
$6,500.00Select
from $350
Ambetter Balanced Care 2 (2019) + Vision
$6,500.00Select
from $359
Community Health Choice HMO Bronze 003
$6,500.00Select
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Brooker, Olmer
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Lodhi, Huma
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Azarcon-samonte, Patricia
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Reister, Gary
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Weber, Alberto
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Mendivil, Rosa
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Orozco, Violeta
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Fajardo, John
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Lambeth, Kelly
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Montes, Jose
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Knoll, Kaylee
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Roa, Daniel
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Mendez, Daniel
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Rubio, Carolyne
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Contreras, Karen
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Cornier, Kenzie
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Abarca, Jose
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Yanez, Kari
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Gutierrez, Nadyne
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Vazquez Diaz, Jose
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Salazar, Miriam
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Ortiz, Bianca
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Navarrette Armstead, Selina
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Olmer Brooker, M.D.
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  • Phone Number
    (915) 855-7900
  • Office Locations
    1418 George Dieter Dr
    El Paso, TX 79936
1418 George Dieter Dr El Paso TX, 79936

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual 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.

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual 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.