MySHL Solutions EPO Bronze 9 Plan Details for 2020- HealthPocket

MySHL Solutions EPO Bronze 9

$267.92/mo

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Zip Code89110
Applicant8/7/1985 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameMySHL Solutions EPO Bronze 9
Plan IDhhs-83198NV0050002
Plan Year2020
Insurance ProviderGolden Rule Insurance
Metal LevelExpanded Bronze
Plan TypeEPO
Deductible$7,000
Out-of-Pocket Maximum$7,900
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$55 Copay
Specialist Visit$100 Copay
Laboratory Outpatient and Professional Services$25 Copay
X-rays and Diagnostic Imaging$65 Copay
Diagnostic Imaging such as MRIs, CT, and PET scansNo Charge after deductible
Deductible - Family$14000 per group
Out-of-Pocket Maximum - Family$15800 per group

Prescription drug coverage

Generic Drugs$25 Copay
Preferred Brand Drugs$75 Copay
Non-Preferred Brand Drugs$150 Copay after deductible
Specialty Drugs50.00% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttp://myshlonline.com/body.cfm?id=25
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?Yes - All
Does this plan cover services outside plan service area?Yes - Urgent and Emergent
Does this plan cover services outside the country?Not Covered

Hospital services

Emergency Room Services$1500 Copay with deductible
Inpatient Hospital Services (e.g., Hospital Stay)No Charge after deductible
Inpatient Physician and Surgical Services20.00% Coinsurance after deductible
Emergency Transportation or Ambulance ServiceNo Charge after deductible

Maternity

Prenatal and Postnatal Care$55 Copay
Delivery and all inpatient services for maternity careNo Charge after deductible

Mental Health

Mental/Behavioral Health Outpatient Services$55 Copay
Mental/Behavioral Health Inpatient ServicesNo Charge after deductible
Substance use disorder outpatient services$55 Copay
Substance use disorder inpatient servicesNo Charge after deductible

Medical Management Programs

Does this plan offer disease managment programs?Asthma, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs
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 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
Private-Duty Nursing
Imaging (CT/PET Scans, MRIs)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Home Health Care Services
Diabetes Care Management
Inherited Metabolic Disorder - PKU
Accidental Dental
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Radiation
Reconstructive Surgery
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Clinical Trials
Prescription Drugs Other
Prescription Drug Other
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
More Limited BenefitsSkilled Nursing Facility
Bariatric Surgery
Hearing Aids
Infertility Treatment
Outpatient Rehabilitation Services
Habilitation Services
Durable Medical Equipment
Hospice Services
Dental Check-Up for Children
Chiropractic Care
Nutritional Counseling
Prosthetic Devices
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
More Excluded BenefitsAcupuncture
Cosmetic Surgery
Long-Term/Custodial Nursing Home Care
Weight Loss Programs
Routine Foot Care
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $279
MyHPN Bronze 10
$7,000.00Select
from $286
MyHPN Bronze 11
$7,000.00Select
from $292
MyHPN Solutions HMO Bronze 10
$7,000.00Select
from $293
MyHPN Solutions HMO Bronze 7
$7,000.00Select
from $322
MyHPN Silver 9
$6,900.00Select
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Carlos, Ezpeleta
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Ahmad, Saab
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Richard, Orr
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David, Rivas
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Gregory, Townsend
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Vanessa, Martin
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Thelma, Durbin
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Jessica, Sanabria
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Binh, Nguyen
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New Mind Primary Care Clinic
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Ronualdo, Robina
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Kallee, Oxborrow
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Logan, Klahn
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Octavia, Maufas
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Joseph, Santos
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Elizabeth, Chapa
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Laura, Girgash
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Trenise, Wilson
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Kirenia, Acosta Vazquez
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Paul, Mitzel
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Antoinette, Garrett
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Carlos Ezpeleta, M.D.
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  • Phone Number
    (702) 383-6250
  • Office Locations
    61 N. Nellis Blvd.
    Las Vegas, NV 89110
61 N. Nellis Blvd. Las Vegas NV, 89110

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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 Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).