UPMC Advantage Inside Advantage for Individuals Platinum $250/$20 - Premium Network Plan Details for 2020- HealthPocket

UPMC Advantage Inside Advantage for Individuals Platinum $250/$20 - Premium Network

$577.97/mo

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Zip Code19120
Applicant2/23/1985 Male

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameUPMC Advantage Inside Advantage for Individuals Platinum $250/$20 - Premium Network
Plan IDqhp-16322PA0040035
Plan Year2019
Insurance ProviderUPMC Health Plan
Metal LevelPlatinum
Plan TypePPO
Deductible$250
Out-of-Pocket Maximum$1,500
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$20 Copay
Specialist Visit10% Coinsurance after deductible
Deductible - Family$500
Out-of-Pocket Maximum - Family$3000

Prescription drug coverage

Generic Drugs$10 Copay
Preferred Brand Drugs$45 Copay
Non-Preferred Brand Drugs$90 Copay
Specialty Drugs50% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttps://www.upmchealthplan.com/marketplace/network.aspx?network=2018_132_IND_PPO_Serv1_Med42_DPPO

Hospital services

Emergency Room Services10% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)10% Coinsurance after deductible
Inpatient Physician and Surgical Services10% Coinsurance after deductible
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  • Phone Number
    (215) 324-2180
  • Office Locations
    448 E Wyoming Ave
    Philadelphia, PA 19120
448 E Wyoming Ave Philadelphia PA, 19120
  • What is the Platinum Plan?

    ObamaCare’s Platinum Plan is a type of Metal Plan on the Health Insurance Marketplace. Platinum Plans qualify for Tax Credits and have the highest premiums. A Platinum Plan is designed to incur the lowest out-of-pocket expenses for enrollees. A typical platinum plan enrollee pays approximately 10% of the costs of covered healthcare services with the plan paying the remainder. In comparison, a typical Bronze Plan enrollee pays 40% of covered medical expenses.

  • How are Platinum Plans different than other Obamacare health plans?

    The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Platinum Plan pays 90% of covered medical costs for a typical enrollee while the other Obamacare health plans pay a lower percentage of these costs.

  • How much does a Platinum Plan cost?

    The monthly premium for a Platinum Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and the region in which you live. You can use HealthPocket’s comparison tool to compare Platinum Plan premiums in your area.

  • When Can I Enroll in a Platinum Plan?

    The Open Enrollment period for the 2018 Affordable Care Act health plans begins November 1, 2017 and ends December 15, 2017. See our Open Enrollment article for more information.

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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).

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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).