AultCare Bronze 5000 Select Plan Details for 2020- HealthPocket

Apply For This Plan

Zip Code43228
Applicant12/15/1984 Male
Apply Now

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameAultCare Bronze 5000 Select
Plan IDqhp-28162OH0060023
Plan Year2020
Insurance ProviderAultCare
Metal LevelExpanded Bronze
Plan TypePPO
Deductible$5,000
Out-of-Pocket Maximum$6,550
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness35% Coinsurance after deductible
Specialist Visit35% Coinsurance after deductible
Laboratory Outpatient and Professional Services35.00% Coinsurance after deductible
X-rays and Diagnostic Imaging35.00% Coinsurance after deductible
Deductible - Family$10000
Out-of-Pocket Maximum - Family$13100

Prescription drug coverage

Generic Drugs35% Coinsurance after deductible
Preferred Brand Drugs35% Coinsurance after deductible
Non-Preferred Brand Drugs35% Coinsurance after deductible
Specialty Drugs35% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttp://directory.aultcare.com/directory/SELECT%20PPO

Hospital services

Emergency Room Services35% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)35% Coinsurance after deductible
Inpatient Physician and Surgical Services35% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care35.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services35.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services35.00% Coinsurance after deductible

Vision Coverage

Routine Eye Exam for Children0.00%
Eye Glasses for Children35.00% Coinsurance after deductible

Exclusions and Limitations

More Included BenefitsOther Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Private-Duty Nursing
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Durable Medical Equipment
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Dental Check-Up for Children
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
Nutritional Counseling
Reconstructive Surgery
More Excluded BenefitsAbortion for Which Public Funding is Prohibited
Infertility Treatment
Long-Term/Custodial Nursing Home Care
Bariatric Surgery
Cosmetic Surgery
Hearing Aids
Routine Foot Care
Acupuncture
Weight Loss Programs
PremiumPlan NameDeductible
from $277
Paramount Bronze 1 HSA
$4,900.00Select
from $317
Anthem Bronze Pathway X HMO 5000
$5,000.00Select
from $332
AultCare Bronze 5000 Select No Pediatric Dental
$5,000.00Select
from $337
Classic Silver Off-Ex Only (Free 24/7 Telemedicine + Free Preve
$5,000.00Select
from $354
Oscar Classic Silver
$5,000.00Select
/
Please select the correct zip
Adnan, Khan
View All Details
Patrick, Callender
View All Details
Paul, Harris
View All Details
Aref, Abou-amro
View All Details
Matthew, Brown
View All Details
Womens Health Center
View All Details
Karen, Vincent
View All Details
Muhammad, Baig
View All Details
Paige, Houghtaling
View All Details
Hayleigh, Tomek
View All Details
Cassondra, Righter
View All Details
Emma, Folk
View All Details
Megan, Sugden
View All Details
Kirstan, Law
View All Details
Tiffany, Pfeil
View All Details
Nina, Henry
View All Details
Fabian, Soto
View All Details
Abigail, Wills
View All Details
Adam, Dennison
View All Details
Jessica, Desalvo
View All Details
Lauren, Lewis
View All Details
Spencer, Hopkins
View All Details
Hayden, Schuette
View All Details
Adnan Khan, M.D.
View All Details
  • Phone Number
    (614) 486-2000
  • Office Locations
    5131 Beacon Hill Rd
    Columbus, OH 43228
5131 Beacon Hill Rd Columbus OH, 43228

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).

Close

Health Plans Found

 

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).