Bronze Essential 7500 EPO UW Medicine Plan Details for 2020- HealthPocket

Bronze Essential 7500 EPO UW Medicine

$294.76/mo

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Zip Code98115
Applicant4/2/1985 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameBronze Essential 7500 EPO UW Medicine
Plan IDhhs-87718WA2150021
Plan Year2020
Insurance ProviderRegence BlueShield
Metal LevelExpanded Bronze
Plan TypeEPO
Deductible$7,500
Out-of-Pocket Maximum$8,150
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$60 Copay with deductible, 10.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Specialist Visit$60 Copay with deductible, 10.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Laboratory Outpatient and Professional Services10.00% Coinsurance after deductible
X-rays and Diagnostic Imaging10.00% Coinsurance after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans10.00% Coinsurance after deductible
Deductible - Family$15000 per group
Out-of-Pocket Maximum - Family$16300 per group

Prescription drug coverage

Generic Drugs$15 Copay
Preferred Brand Drugs20.00% Coinsurance after deductible
Non-Preferred Brand Drugs50.00% Coinsurance after deductible
Specialty Drugs40.00% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttps://www.regence.com/web/regence_individual/finding-doctors
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 Services10.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)10.00% Coinsurance after deductible
Inpatient Physician and Surgical Services10.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service10.00% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care10.00% Coinsurance after deductible
Delivery and all inpatient services for maternity care10.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services10.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services10.00% Coinsurance after deductible
Substance use disorder outpatient services10.00% Coinsurance after deductible
Substance use disorder inpatient services10.00% Coinsurance after deductible

Medical Management Programs

Does this plan offer disease managment programs?Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Pain Management, Pregnancy
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 - OrthodontiaIncluded
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
Hearing Aids
Imaging (CT/PET Scans, MRIs)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Durable Medical Equipment
Dental Anesthesia
Diabetes Care Management
Inherited Metabolic Disorder - PKU
Abortion for Which Public Funding is Prohibited
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)
More Limited BenefitsSkilled Nursing Facility
Acupuncture
Home Health Care Services
Outpatient Rehabilitation Services
Habilitation Services
Hospice Services
Dental Check-Up for Children
Chiropractic Care
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
More Excluded BenefitsBariatric Surgery
Cosmetic Surgery
Infertility Treatment
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Weight Loss Programs
Routine Foot Care
Accidental Dental
Allergy Testing
PremiumPlan NameDeductible
from $296
Bronze Essential 7500 EPO MultiCare Connected Care
$7,500.00Select
from $298
Bronze Essential 7500 EPO RealValue
$7,500.00Select
from $312
Bronze Essential 7500 EPO PeaceHealth
$7,500.00Select
from $333
Bronze Essential 7500 EPO Individual and Family Network
$7,500.00Select
from $361
Bronze Essential 7500 EPO Individual and Family Network
$7,500.00Select
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Jonathan, Moceri
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Sheryl, Morelli
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David, Viscardi
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Bethanie, Bayha
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Ashley, Jerath Tatum
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Therese, Law
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Kiwnai, Allen
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John, Young
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David, Sullivan
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Erika, Clute
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Ryan, Wilson
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Samantha, Vanderputten
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Sametra, Green
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Rachel, Smith
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Sierra, Owsley
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Margaret, Flack
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Maegan, Bell
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Courtney, Rogers
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Lisa, Geiver
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Rebecca, Wilkins
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Seth, Moreno
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Anton, Krioukov
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George, Martin
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Jonathan Moceri, MD
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  • Phone Number
    (206) 954-5525
  • Office Locations
    1037 Ne 65th St
    Seattle, WA 98115
1037 Ne 65th St Seattle WA, 98115

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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).