Shared Cost Blue EPO Bronze 7800 - 1 Free PCP Visit Plan Details for 2020- HealthPocket

Shared Cost Blue EPO Bronze 7800 - 1 Free PCP Visit

$306.70/mo

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Zip Code19805
Applicant4/1/1985 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameShared Cost Blue EPO Bronze 7800 - 1 Free PCP Visit
Plan IDqhp-76168DE0410022
Plan Year2020
Insurance ProviderHighmark
Metal LevelExpanded Bronze
Plan TypeEPO
Deductible$7,800
Out-of-Pocket Maximum$7,900
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness40% Coinsurance after deductible
Specialist Visit40% Coinsurance after deductible
Laboratory Outpatient and Professional Services40.00% Coinsurance after deductible
X-rays and Diagnostic Imaging40.00% Coinsurance after deductible
Deductible - Family$15600
Out-of-Pocket Maximum - Family$15800

Prescription drug coverage

Generic DrugsNo Charge
Preferred Brand Drugs$20 Copay
Non-Preferred Brand Drugs35% Coinsurance after deductible
Specialty Drugs50% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttps://www.highmarkbcbsde.com/find-a-doctor/#/home

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 Care40.00% Coinsurance after deductible

Mental Health

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

Vision Coverage

Routine Eye Exam for ChildrenNo Charge
Eye Glasses for ChildrenNo Charge

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
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
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
Clinical Trials
Diabetes Care Management
Inherited Metabolic Disorder - PKU
More Excluded BenefitsLong-Term/Custodial Nursing Home Care
Cosmetic Surgery
Routine Foot Care
Acupuncture
Weight Loss Programs
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $290
Shared Cost Blue EPO Bronze 7900
$7,900.00Select
from $355
Shared Cost Blue EPO Bronze 7900
$7,900.00Select
from $374
Shared Cost Blue EPO Bronze 7800 - 1 Free PCP Visit
$7,800.00Select
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  • Phone Number
    (302) 575-8092
  • Office Locations
    701 N Clayton St
    Wilmington, DE 19805
701 N Clayton St Wilmington DE, 19805

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HealthPocket.com provides information on insurance products. If you choose to obtain a quote or apply for an insurance plan, you may be transferred to a partner website to complete your request. Always review the privacy and terms of use of the partner website.

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).