PreferredHealth Expanded Bronze 27 Plan Details for 2020- HealthPocket

PreferredHealth Expanded Bronze 27

$213.92/mo

Apply For This Plan

Zip Code55106
Applicant2/18/1985 Male
Apply Now

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NamePreferredHealth Expanded Bronze 27
Plan IDhhs-88102MN0010027
Plan Year2020
Insurance ProviderPreferredOne Insurance Company
Metal LevelExpanded Bronze
Plan TypePPO
Deductible$6,000
Out-of-Pocket Maximum$6,900
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness30.00% Coinsurance after deductible
Specialist Visit30.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services30.00% Coinsurance after deductible
X-rays and Diagnostic Imaging30.00% Coinsurance after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans30.00% Coinsurance after deductible
Deductible - Family$12000 per group
Out-of-Pocket Maximum - Family$13800 per group

Prescription drug coverage

Generic Drugs30.00% Coinsurance after deductible
Preferred Brand Drugs30.00% Coinsurance after deductible
Specialty Drugs50.00% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttp://providerguide.preferredone.com/Default.asp?Network=OA200
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?Yes - Applied to out of network deductible and Coinsurance
Does this plan cover services outside the country?Yes - Emergency Only

Hospital services

Emergency Room Services30.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)30.00% Coinsurance after deductible
Inpatient Physician and Surgical Services30.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service30.00% Coinsurance after deductible

Maternity

Prenatal and Postnatal CareNo Charge
Delivery and all inpatient services for maternity 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
Substance use disorder outpatient services30.00% Coinsurance after deductible
Substance use disorder inpatient services30.00% Coinsurance after deductible

Medical Management Programs

Does this plan offer disease managment programs?Asthma, Depression, Diabetes, Heart Disease, Low Back Pain, Pregnancy
Does this plan offer a wellness program?Included

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 CareNot Covered
Child Dental Coverage - Basic Dental CareNot Covered
Child Dental Coverage - OrthodontiaNot Covered
Child Dental Coverage - Major Dental CareNot Covered

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
Cosmetic Surgery
Weight Loss Programs
Imaging (CT/PET Scans, MRIs)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Outpatient Rehabilitation Services
Habilitation Services
Durable Medical Equipment
Chiropractic Care
Routine Foot Care
Dental Anesthesia
Diabetes Care Management
Inherited Metabolic Disorder - PKU
Accidental Dental
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Congenital Anomaly, including Cleft Lip/Palate
Off Label Prescription Drugs
Port-Wine Stain Removal
Prescription Drugs Other
Treatment of Lyme Disease
Genetic Testing
Biofeedback
Diethylstilbestrol Exposure Treatment
Infertility Diagnosis
Routine Patient Cost for Clinical Trials
Testing for STD's
Treatment for STD's
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Treatment for children with emotional disorders
Insulin and other glucose lowering agents
More Limited BenefitsSkilled Nursing Facility
Hearing Aids
Private-Duty Nursing
Inpatient Physician and Surgical Services
Home Health Care Services
Hospice Services
More Excluded BenefitsAcupuncture
Bariatric Surgery
Infertility Treatment
Long-Term/Custodial Nursing Home Care
Dental Check-Up for Children
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $240
Pic 5450
$6,000.00Select
from $257
SmartCare $6000 Plus Bronze
$6,000.00Select
from $262
Peak $6000 Plus Bronze
$6,000.00Select
/
Please select the correct zip
Johnn, Gaertner
View All Details
Peter, Cermak
View All Details
Peter, Yang
View All Details
The Doctors Medical Clinic
View All Details
Andria, Strawn
View All Details
Lois, Berndt
View All Details
Susan, Sanches
View All Details
Susan, Ferrell
View All Details
Tracy, Schrantz
View All Details
Lynn, Anderson
View All Details
Amy, Feesl
View All Details
Risa, Bache-wiig
View All Details
Stephanie, Henigin
View All Details
Katie, Knutson
View All Details
Megan, Goodell
View All Details
Molly, Given
View All Details
Kayley, Mikolajczyk
View All Details
Denise, Small
View All Details
Kayla, Harris
View All Details
Benjamin, Rosenstein
View All Details
Johnn Gaertner, M.D.
View All Details
  • Phone Number
    (651) 793-3100
  • Office Locations
    651 Arcade St
    Saint Paul, MN 55106
651 Arcade St Saint Paul MN, 55106

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).

Close

Health Plans Found

 

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).