Bronze HSA 2 Plan Details for 2020- HealthPocket

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Zip Code28269
Applicant1/25/1985 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameBronze HSA 2
Plan IDqhp-37900NC0010037
Plan Year2020
Insurance ProviderBright Health
Metal LevelExpanded Bronze
Plan TypeHMO
Deductible$6,850
Out-of-Pocket Maximum$6,850
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or IllnessNo Charge after Deductible
Specialist VisitNo Charge after Deductible
Laboratory Outpatient and Professional Services0.00%
X-rays and Diagnostic Imaging0.00%
Deductible - Family$13700
Out-of-Pocket Maximum - Family$13700

Prescription drug coverage

Generic DrugsNo Charge after Deductible
Preferred Brand DrugsNo Charge after Deductible
Non-Preferred Brand DrugsNo Charge after Deductible
Specialty DrugsNo Charge after Deductible

Access to doctors and hospitals

Provider directory URLhttps://brighthealthplan.com/provider-finder/ifp/nc-nov

Hospital services

Emergency Room ServicesNo Charge after Deductible
Inpatient Hospital Services (e.g., Hospital Stay)No Charge after Deductible
Inpatient Physician and Surgical ServicesNo Charge after Deductible

Maternity

Prenatal and Postnatal CareNo Charge after deductible

Mental Health

Mental/Behavioral Health Outpatient ServicesNo Charge after deductible
Mental/Behavioral Health Inpatient ServicesNo Charge after deductible

Vision Coverage

Routine Eye Exam for Children0.00%
Eye Glasses for Children0.00%

Exclusions and Limitations

More Included BenefitsDental 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
Other Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Infertility Treatment
Private-Duty Nursing
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Bariatric Surgery
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Durable Medical Equipment
Hearing Aids
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Reconstructive Surgery
More Excluded BenefitsWeight Loss Programs
Abortion for Which Public Funding is Prohibited
Long-Term/Custodial Nursing Home Care
Cosmetic Surgery
Routine Foot Care
Acupuncture
PremiumPlan NameDeductible
from $245
Blue Home Bronze 6900 (local network with UNC Health Alliance, HSA eligible)
$6,900.00Select
from $252
Blue Local Bronze 6900 (local network with Wake Forest Baptist Health, HSA eligible)
$6,900.00Select
from $302
Blue Local Bronze 6900 (local network with Atrium Health, HSA eligible)
$6,900.00Select
from $328
Blue Value Bronze 6900 (limited network, HSA eligible)
$6,900.00Select
from $371
Bronze HSA 1
$6,850.00Select
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  • Phone Number
    (704) 863-9830
  • Office Locations
    5727 Prosperity Crossing Drive
    Charlotte, NC 28269
5727 Prosperity Crossing Drive Charlotte NC, 28269

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).