Oscar Classic Bronze Next Plan Details for 2020- HealthPocket

Oscar Classic Bronze Next

$326.93/mo

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Zip Code80219
Applicant2/26/1985 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameOscar Classic Bronze Next
Plan IDhhs-44559CO0010005
Plan Year2020
Insurance ProviderOscar Insurance Company
Metal LevelExpanded Bronze
Plan TypeEPO
Deductible$0
Out-of-Pocket Maximum$8,150
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$50 Copay
Specialist Visit$90 Copay
Laboratory Outpatient and Professional Services$50 Copay
X-rays and Diagnostic Imaging$90 Copay
Diagnostic Imaging such as MRIs, CT, and PET scans$200 Copay
Deductible - Family$0 per group
Out-of-Pocket Maximum - Family$16300 per group

Prescription drug coverage

Generic Drugs$25 Copay
Preferred Brand Drugs$200 Copay
Non-Preferred Brand Drugs50.00% Coinsurance after deductible
Specialty Drugs50.00% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttp://www.hioscar.com/search
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?Not Covered
Does this plan cover services outside plan service area?Not Covered
Does this plan cover services outside the country?Not Covered

Hospital services

Emergency Room Services$1000 Copay
Inpatient Hospital Services (e.g., Hospital Stay)$3000 Copay per Day
Inpatient Physician and Surgical Services$300 Copay
Emergency Transportation or Ambulance Service$1000 Copay

Maternity

Prenatal and Postnatal CareNot Applicable
Delivery and all inpatient services for maternity care$3000 Copay

Mental Health

Mental/Behavioral Health Outpatient Services$50 Copay
Mental/Behavioral Health Inpatient Services$3000 Copay per Day
Substance use disorder outpatient services$50 Copay
Substance use disorder inpatient services$3000 Copay per Day

Medical Management Programs

Does this plan offer a wellness program?Not Covered

Vision Coverage

Routine Eye Exam for ChildrenIncluded
Eye Glasses for ChildrenIncluded
Routine Eye Exam for AdultsNot Covered

Child Dental Coverage

Child Dental Coverage - Routine Dental CareIncluded
Child Dental Coverage - Basic Dental CareIncluded
Child Dental Coverage - OrthodontiaNot Covered
Child Dental Coverage - Major Dental CareIncluded

Adult Dental Coverage

Adult Dental Coverage - Routine Dental CareNot Covered
Adult Dental Coverage - Basic Dental CareNot Covered
Adult Dental Coverage - OrthodontiaNot Covered
Adult Dental Coverage - Major Dental CareNot Covered

Exclusions and Limitations

More Included BenefitsOther Practitioner Office Visit (Nurse, Physician Assistant)
Preventive Care/Screening/Immunization
Bariatric Surgery
Hearing Aids
Infertility Treatment
Private-Duty Nursing
Imaging (CT/PET Scans, MRIs)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Durable Medical Equipment
Hospice Services
Dental Check-Up for Children
Applied Behavior Analysis Based Therapies
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Prosthetics: Legs and Arms
Telehealth PCP
Telehealth Specialist
Intensive Outpatient for Substance Use Disorder
Mental/Behavioral Health Prenatal Care
Partial Hospitalization for Mental/Behavioral Health
Partial Hospitalization for Substance Use Disorder
Postpartum Mental/Behavioral Health
Postpartum Substance Use Disorder
Residential Day Treatment for Mental/Behavioral Health
Residential Day Treatment for Substance Use Disorder
Substance Use Disorder Prenatal Care
Telehealth Mental/Behavioral Health
Telehealth Substance Use Disorder
Autism Spectrum Disorders - Assessment and Evaluation Services
Intensive Outpatient for Mental/Behavioral Health
More Limited BenefitsSkilled Nursing Facility
Home Health Care Services
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
Rehabilitative Occupational Therapy
Rehabilitative Physical Therapy
More Excluded BenefitsAcupuncture
Cosmetic Surgery
Long-Term/Custodial Nursing Home Care
Weight Loss Programs
Routine Foot Care
Abortion for Which Public Funding is Prohibited
Accidental Dental
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  • Phone Number
    (303) 935-9142
  • Office Locations
    1930 S Federal Blvd
    Denver, CO 80219
1930 S Federal Blvd Denver CO, 80219

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).