Select $6,000 HDHP Plan Details for 2020- HealthPocket

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Zip Code53215
Applicant2/25/1985 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameSelect $6,000 HDHP
Plan IDqhp-38166WI0180022
Plan Year2020
Insurance ProviderSecurity Health Plan
Metal LevelExpanded Bronze
Plan TypeEPO
Deductible$6,000
Out-of-Pocket Maximum$6,850
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or IllnessNo Charge after Deductible
Specialist Visit$75 Copay
Laboratory Outpatient and Professional ServicesNo Charge after deductible
X-rays and Diagnostic ImagingNo Charge after deductible
Deductible - Family$12000
Out-of-Pocket Maximum - Family$13700

Prescription drug coverage

Generic Drugs$25 Copay
Preferred Brand Drugs$80 Copay
Non-Preferred Brand Drugs$150 Copay
Specialty Drugs45% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttp://www.securityhealth.org/selectproviders

Hospital services

Emergency Room Services$450 Copay
Inpatient Hospital Services (e.g., Hospital Stay)No Charge after Deductible
Inpatient Physician and Surgical Services$250 Copay

Maternity

Prenatal and Postnatal CareNo Charge after deductible

Mental Health

Mental/Behavioral Health Outpatient ServicesNo Charge after deductible
Mental/Behavioral Health Inpatient ServicesNo Charge after deductible

Vision Coverage

Routine Eye Exam for ChildrenNo Charge
Eye Glasses for ChildrenNo Charge after deductible

Exclusions and Limitations

More Included BenefitsOutpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Durable Medical Equipment
Hearing Aids
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Rehabilitative Speech Therapy
Rehabilitative Occupational and Rehabilitative Physical Therapy
Chemotherapy
Radiation
Diabetes Education
Prosthetic Devices
Infusion Therapy
Treatment for Temporomandibular Joint Disorders
Nutritional Counseling
Reconstructive Surgery
Autism Spectrum Disorders
Other Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Skilled Nursing Facility
Well Baby Visits and Care
Transplant
Accidental Dental
Dialysis
Allergy Testing
Cardiac Rehabilitation
Clinical Trials
Dental Anesthesia
More Excluded BenefitsRoutine Foot Care
Acupuncture
Weight Loss Programs
Dental Check-Up for Children
Infertility Treatment
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Bariatric Surgery
Cosmetic Surgery
Abortion for Which Public Funding is Prohibited
Diabetes Care Management
Mental Health Other
Prescription Drugs Other
Newborn Services Other
PremiumPlan NameDeductible
from $328
MercyCare HMO Silver Option C
$5,800.00Select
from $337
Prestige Bronze 20 HDHP + Dental + Vision
$6,000.00Select
from $368
Constant Care Silver 1
$6,000.00Select
from $371
Constant Care Silver 1 + Vision
$6,000.00Select
from $420
Prestige Bronze 20 HDHP + Dental + Vision
$6,000.00Select
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John Hanson, M.D.
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  • Phone Number
    (414) 385-3086
  • Office Locations
    2901 W Kinnickinnic River Pkwy
    Milwaukee, WI 53215
2901 W Kinnickinnic River Pkwy Milwaukee WI, 53215

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).