Market HMO 8000 - Mercy Plan Details for 2020- HealthPocket

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Zip Code43228
Applicant10/20/1985 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameMarket HMO 8000 - Mercy
Plan IDqhp-99969OH0080192
Plan Year2020
Insurance ProviderMedical Mutual
Metal LevelExpanded Bronze
Plan TypeHMO
Deductible$8,000
Out-of-Pocket Maximum$8,150
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness30% Coinsurance after deductible
Specialist Visit30% Coinsurance after deductible
Laboratory Outpatient and Professional Services30.00% Coinsurance after deductible
X-rays and Diagnostic Imaging30.00% Coinsurance after deductible
Deductible - Family$16000
Out-of-Pocket Maximum - Family$16300

Prescription drug coverage

Generic Drugs$25 Copay
Preferred Brand Drugs$50 Copay
Non-Preferred Brand Drugs50% Coinsurance after deductible
Specialty Drugs50% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttps://providersearch.medmutual.com/default.aspx?product=SM%2b

Hospital services

Emergency Room Services30% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)30% Coinsurance after deductible
Inpatient Physician and Surgical Services30% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care30.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services30.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services30.00% Coinsurance after deductible

Vision Coverage

Routine Eye Exam for ChildrenNo Charge
Eye Glasses for Children30.00% 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
Infertility Treatment
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
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
Chiropractic Care
Durable Medical Equipment
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
More Excluded BenefitsLong-Term/Custodial Nursing Home Care
Bariatric Surgery
Cosmetic Surgery
Dental Check-Up for Children
Abortion for Which Public Funding is Prohibited
Hearing Aids
Routine Foot Care
Acupuncture
Weight Loss Programs
PremiumPlan NameDeductible
from $159
Market HMO Young Adult Essentials - Mercy
$8,150.00Select
from $184
Market HMO Young Adult Essentials - Dayton
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from $192
Market HMO Young Adult Essentials - OhioHealth
$8,150.00Select
from $195
Market HMO Young Adult Essentials - NE Ohio
$8,150.00Select
from $200
Ambetter Essential Care 1 (2020)
$8,150.00Select
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  • Phone Number
    (614) 870-0000
  • Office Locations
    5212 W Broad St
    Columbus, OH 43228
5212 W Broad St Columbus OH, 43228

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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 Benefytt Technologies, Inc. family of companies.