Personal Choice EPO Bronze Basic Plan Details for 2021- HealthPocket

ZIP Code
County
Applicant Info
Applicant
Date of birth
//
Gender
male
female
Income
$

Apply For This Plan

Zip Code	19120 (edit)
Applicant	1/18/1986 Male (edit)

Insurance Type	ACA (Obamacare)
Plan Name	Personal Choice EPO Bronze Basic
Plan ID	hhs-31609PA0180005
Plan Year	2020
Insurance Provider	Independence Blue Cross
Metal Level	Bronze
Plan Type	EPO
Deductible	$8,150
Out-of-Pocket Maximum	$8,150
Plan Highlights

Costs for Medical Care
Primary Care Visit to Treat an Injury or Illness	$40 Copay
Specialist Visit	No Charge after deductible
Laboratory Outpatient and Professional Services	No Charge after deductible
X-rays and Diagnostic Imaging	No Charge after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans	No Charge after deductible
Deductible - Family	$16300 per group
Out-of-Pocket Maximum - Family	$16300 per group

Prescription drug coverage
Generic Drugs	No Charge after deductible
Preferred Brand Drugs	No Charge after deductible
Non-Preferred Brand Drugs	No Charge after deductible
Specialty Drugs	No Charge after deductible

Access to doctors and hospitals
Provider directory URL	http://www.ibx.com/providerfinder
Does this plan have access to a national provider network?	Yes
Is a referral required to see a Specialist?	Not Covered
Does this plan cover services outside plan service area?	Yes - Coverage is provided for benefits received anywhere in the U.S.
Does this plan cover services outside the country?	Yes - Coverage is provided for benefits received while outside of the U.S.

Hospital services
Emergency Room Services	No Charge after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	No Charge after deductible
Inpatient Physician and Surgical Services	No Charge after deductible
Emergency Transportation or Ambulance Service	No Charge after deductible

Maternity
Prenatal and Postnatal Care	No Charge after deductible
Delivery and all inpatient services for maternity care	No Charge after deductible

Mental Health
Mental/Behavioral Health Outpatient Services	No Charge after deductible
Mental/Behavioral Health Inpatient Services	No Charge after deductible
Substance use disorder outpatient services	No Charge after deductible
Substance use disorder inpatient services	No Charge after deductible

Medical Management Programs
Does this plan offer disease managment programs?	Asthma, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pregnancy
Does this plan offer a wellness program?	Not Covered

Vision Coverage
Routine Eye Exam for Children	Included
Eye Glasses for Children	Included
Routine Eye Exam for Adults	Not Covered

Child Dental Coverage
Child Dental Coverage - Routine Dental Care	Included
Child Dental Coverage - Basic Dental Care	Included
Child Dental Coverage - Orthodontia	Included
Child Dental Coverage - Major Dental Care	Included

Adult Dental Coverage
Adult Dental Coverage - Routine Dental Care	Not Covered
Adult Dental Coverage - Basic Dental Care	Not Covered
Adult Dental Coverage - Orthodontia	Not Covered
Adult Dental Coverage - Major Dental Care	Not Covered

Exclusions and Limitations
More Included Benefits	Other Practitioner Office Visit (Nurse, Physician Assistant) Preventive Care/Screening/Immunization Infertility Treatment Imaging (CT/PET Scans, MRIs) Outpatient Facility Fee (e.g., Ambulatory Surgery Center) Outpatient Surgery Physician/Surgical Services Urgent Care Centers or Facilities Inpatient Physician and Surgical Services Durable Medical Equipment Hospice Services Dental Anesthesia Diabetes Care Management Inherited Metabolic Disorder - PKU Abortion for Which Public Funding is Prohibited Accidental Dental Allergy Testing Chemotherapy Diabetes Education Dialysis Infusion Therapy Laboratory Outpatient and Professional Services Prosthetic Devices Radiation Reconstructive Surgery Transplant Well Baby Visits and Care Telemedicine Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
More Limited Benefits	Skilled Nursing Facility Home Health Care Services Outpatient Rehabilitation Services Habilitation Services Dental Check-Up for Children Chiropractic Care Nutritional Counseling Rehabilitative Occupational and Rehabilitative Physical Therapy Rehabilitative Speech Therapy
More Excluded Benefits	Acupuncture Bariatric Surgery Cosmetic Surgery Hearing Aids Long-Term/Custodial Nursing Home Care Private-Duty Nursing Weight Loss Programs Routine Foot Care Treatment for Temporomandibular Joint Disorders

+ See All Coverage Details

Premium	Plan Name	Deductible
from $309	Ambetter Essential Care 1 (2021)	$8,300.00	Select
from $328	Ambetter Essential Care 1 (2021) + Vision + Adult Dental	$8,300.00	Select

Last Name

Location/Distance

Please select the correct zip

Kenneth, Nguyen

View All Details

Ronald, Small

View All Details

Julie, Massey

View All Details

Loganathan, Parthipan

View All Details

Boris, Itskov

View All Details

Holy Redeemer Family Health Center

View All Details

Andre, Wallace

View All Details

Alan, Duong

View All Details

Complete Wellness Rehabilitation, Llc

View All Details

David, Ross

View All Details

Dedicated Pennsylvania Holding, Llc

View All Details

Einstein Pediatrics Associates Specialists

View All Details

Einstein Community Health Associates, Inc.

View All Details

Einstein Community Health Associates, Inc

View All Details

Einstein Community Health Associates, Inc

Indira, Martinez

Vip Healthcare Group

Kenneth Nguyen, M.D.

Phone Number
(215) 324-2180
Office Locations
448 E Wyoming Ave
Philadelphia, PA 19120

448 E Wyoming Ave Philadelphia PA, 19120

What is a bronze plan?
Bronze Plan is a type of Metal Plan on the Health Insurance Marketplace. Bronze Plans qualify for Tax Credits and have low premiums. Generally speaking, a Bronze Plan is intended to have the lowest premium of the 4 new categories of health plans under the Affordable Care Act but charge the highest out-of-pocket costs for healthcare services.
How are Bronze 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 Bronze Plan pays 60% of the covered medical costs among its enrollees while the other Obamacare health plans pay a higher percentage of these costs.
How much does a Bronze Plan cost?
The monthly premium for a Bronze 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 Bronze Plan premiums in your area. Another important factor to remember is Advanced Premium Tax Credits which can subsidize bronze plan premiums if an individual meets eligibility criteria.
When Can I Enroll in a Bronze Plan?
The annual enrollment period for the 2018 plan year will begin on November 1, 2017 and continue through December 15, 2017.
In 2015 there had been a Special Enrollment Period for many facing the uninsured penalty on their 2014 tax return. There is no guarantee that a similar Special Enrollment Period will be granted in 2017. See our Open Enrollment article for more information.

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 Benefytt Technologies, Inc. family of companies.

ZIP Code
County
Applicant Info
Applicant
Date of birth
//
Gender
male
female
Income
$

Health Plans Found

Sort by

We do not have any data on plans available in your area. Please contact www.healthcare.gov.

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.

Personal Choice EPO Bronze Basic

Apply For This Plan

Benefits & Coverage

Costs for Medical Care

Prescription drug coverage

Access to doctors and hospitals

Hospital services

Maternity

Mental Health

Medical Management Programs

Vision Coverage

Child Dental Coverage

Adult Dental Coverage

Exclusions and Limitations

Similar Plans

Physician Finder

Related Articles

Related Searches

Bronze plan frequently asked questions (FAQ)

What is a bronze plan?

How are Bronze Plans different than other Obamacare health plans?

How much does a Bronze Plan cost?

When Can I Enroll in a Bronze Plan?

Apply For This Plan

Health Plans Found