Total Saver Plus Plan Details for 2020- HealthPocket

Apply For This Plan

Zip Code48228
Applicant10/20/1985 Male
Apply Now

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameTotal Saver Plus
Plan IDhhs-67183MI0030005
Plan Year2020
Insurance ProviderTotal Health Care
Metal LevelBronze
Plan TypeHMO
Deductible$5,500
Out-of-Pocket Maximum$8,150
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$25 Copay after deductible
Specialist Visit$50 Copay 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$11000 per group
Out-of-Pocket Maximum - Family$16300 per group

Prescription drug coverage

Generic Drugs$20 Copay
Preferred Brand Drugs30.00% Coinsurance after deductible
Non-Preferred Brand Drugs30.00% Coinsurance after deductible
Specialty Drugs30.00% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttp://www.thcmi.com
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?Yes - Podiatry, Chiropractic
Does this plan cover services outside plan service area?Yes - Emergency
Does this plan cover services outside the country?Yes - Emergency

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 Service$75 Copay

Maternity

Prenatal and Postnatal CareNo Charge
Delivery and all inpatient services for maternity care30.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services$50 Copay after deductible
Mental/Behavioral Health Inpatient Services30.00% Coinsurance after deductible
Substance use disorder outpatient services$50 Copay after deductible
Substance use disorder inpatient services30.00% Coinsurance after deductible

Medical Management Programs

Does this plan offer disease managment programs?Asthma, Diabetes, High Blood Pressure & High Cholesterol, Pregnancy, Weight Loss 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 AdultsIncluded

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
Infertility Treatment
Weight Loss Programs
Imaging (CT/PET Scans, MRIs)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Home Health Care Services
Durable Medical Equipment
Hospice Services
Mental Health Other
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Prosthetic Devices
Radiation
Reconstructive Surgery
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Prescription Drugs Other
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Habilitative Devices
Rehabilitative Devices
More Limited BenefitsSkilled Nursing Facility
Bariatric Surgery
Hearing Aids
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Nutritional Counseling
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
Eyeglasses for Adults
More Excluded BenefitsAcupuncture
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Dental Check-Up for Children
Routine Foot Care
Abortion for Which Public Funding is Prohibited
Accidental Dental
PremiumPlan NameDeductible
from $175
Total Saver Plus
$5,500.00Select
from $207
Meridian HSA Savings Bronze
$5,500.00Select
from $234
Meridian HSA Savings Bronze
$5,500.00Select
from $237
Oscar Classic Bronze
$5,500.00Select
from $237
HAP Personal Alliance HMO Genesys Choice Bronze 5500
$5,500.00Select
/
Please select the correct zip
William, Prechel
View All Details
Satish, Khanzode
View All Details
Physio Matrix Inc.
View All Details
Prince, Eubanks
View All Details
Prechel Family Clinic, Pc
View All Details
Halo Pediatrics
View All Details
Deidre, Flowers
View All Details
Javid, Khan
View All Details
Janet, Lang
View All Details
Rynicia, Caldwell
View All Details
Iamerica Behavioral & Mental Health
View All Details
Wadeeah, Alshawi
View All Details
Deandra, Robinson
View All Details
Karen, Eddings-howell
View All Details
Vannessa, Robinson
View All Details
Mojtaba, Al-modhafir
View All Details
Taylor, Banks
View All Details
Joel, Shreve
View All Details
Briana, Lamar
View All Details
Roxsanna, Collins
View All Details
Roslyn, Mcgee
View All Details
William Prechel, D.O.
View All Details
  • Phone Number
    (313) 584-3624
  • Office Locations
    16551 W Warren Ave
    Detroit, MI 48228
16551 W Warren Ave Detroit MI, 48228
  • What is a bronze plan?

    Bronze Plan is a type of Metal Plan on the Health Insurance Marketplace. Bronze Plans qualify for Tax Credits and have low premiums. Generally speaking, a Bronze Plan is intended to have the lowest premium of the 4 new categories of health plans under the Affordable Care Act but charge the highest out-of-pocket costs for healthcare services.

  • How are Bronze Plans different than other Obamacare health plans?

    The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Bronze Plan pays 60% of the covered medical costs among its enrollees while the other Obamacare health plans pay a higher percentage of these costs.

  • How much does a Bronze Plan cost?

    The monthly premium for a Bronze Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and the region in which you live. You can use HealthPocket’s comparison tool to compare Bronze Plan premiums in your area. Another important factor to remember is Advanced Premium Tax Credits which can subsidize bronze plan premiums if an individual meets eligibility criteria.

  • When Can I Enroll in a Bronze Plan?

    The annual enrollment period for the 2018 plan year will begin on November 1, 2017 and continue through December 15, 2017.

    In 2015 there had been a Special Enrollment Period for many facing the uninsured penalty on their 2014 tax return. There is no guarantee that a similar Special Enrollment Period will be granted in 2017. See our Open Enrollment article for more information.

Read More

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 Benefytt Technologies, Inc. family of companies.

Health Plans Found

 

HealthPocket.com provides information on insurance products. If you choose to obtain a quote or apply for an insurance plan, you may be transferred to a partner website to complete your request. Always review the privacy and terms of use of the partner website.

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 Benefytt Technologies, Inc. family of companies.