Personal Choice EPO Bronze Basic Plan Details for 2020- HealthPocket

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Applicant Info
Applicant
Date of birth
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female
Income
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Zip Code	19120 (edit)
Applicant	3/30/1985 Male (edit)

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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	$0
Out-of-Pocket Maximum	$0
Plan Highlights

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.

Medical Management Programs
Does this plan offer disease managment programs?	Asthma, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, 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

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Last Name

Location/Distance

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Kenneth, Nguyen

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Ronald, Small

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Julie, Massey

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Loganathan, Parthipan

Boris, Itskov

Adriana, Navas

Alan, Duong

Complete Wellness Rehabilitation, Llc

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David, Ross

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Dedicated Pennsylvania Holding, Llc

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Einstein Pediatrics Associates Specialists

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Einstein Community Health Associates, Inc.

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Einstein Community Health Associates, Inc

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Einstein Community Health Associates, Inc

Vip Healthcare Group

Syed, Zahid

Chanelle, Rice

Diane, Clauss

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 Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).

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Applicant
Date of birth
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Income
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Personal Choice EPO Bronze Basic

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Benefits & Coverage

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Medical Management Programs

Vision Coverage

Child Dental Coverage

Adult Dental Coverage

Exclusions and Limitations

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