WellFirst Bronze HSA-E 6700X Plan Details for 2020- HealthPocket

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Zip Code63129
Applicant2/17/1985 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameWellFirst Bronze HSA-E 6700X
Plan IDqhp-47840MO0010009
Plan Year2020
Insurance ProviderSSM Health Insurance Company
Metal LevelExpanded Bronze
Plan TypeEPO
Deductible$6,700
Out-of-Pocket Maximum$6,700
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or IllnessNo Charge after Deductible
Specialist VisitNo Charge after Deductible
Laboratory Outpatient and Professional ServicesNo Charge after deductible
X-rays and Diagnostic ImagingNo Charge after deductible
Deductible - Family$13400
Out-of-Pocket Maximum - Family$13400

Prescription drug coverage

Generic DrugsNo Charge after Deductible
Preferred Brand DrugsNo Charge after Deductible
Non-Preferred Brand DrugsNo Charge after Deductible
Specialty DrugsNo Charge after Deductible

Access to doctors and hospitals

Provider directory URLhttp://www.wellfirstbenefits.com/find-a-doc/marketplace-epo-plan-providers/

Hospital services

Emergency Room ServicesNo Charge after Deductible
Inpatient Hospital Services (e.g., Hospital Stay)No Charge after Deductible
Inpatient Physician and Surgical ServicesNo Charge after Deductible

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 after deductible
Eye Glasses for ChildrenNo Charge after deductible

Exclusions and Limitations

More Included BenefitsOutpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Private-Duty Nursing
Urgent Care Centers or Facilities
Other Practitioner Office Visit (Nurse, Physician Assistant)
Home Health Care Services
Inpatient Physician and Surgical Services
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Durable Medical Equipment
Hearing Aids
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Routine Foot Care
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
More Excluded BenefitsInfertility Treatment
Long-Term/Custodial Nursing Home Care
Bariatric Surgery
Cosmetic Surgery
Acupuncture
Weight Loss Programs
Dental Check-Up for Children
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $293
WellFirst Bronze HSA-E 6750
$6,750.00Select
from $294
WellFirst Bronze HSA-E 6700X
$6,700.00Select
from $388
Oscar Classic Silver
$6,500.00Select
from $415
Ambetter Balanced Care 12 (2020)
$6,500.00Select
from $421
Anthem Bronze Pathway X 0 for HSA
$6,850.00Select
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  • Phone Number
    (314) 487-8724
  • Office Locations
    4530 Lemay Ferry Rd
    Saint Louis, MO 63129
4530 Lemay Ferry Rd Saint Louis MO, 63129

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).