Oscar Bronze HDHP (HSA-Compatible Plan + Free 24/7 Virtual Visi Plan Details for 2021- HealthPocket

Oscar Bronze HDHP (HSA-Compatible Plan + Free 24/7 Virtual Visi

$327.78/mo

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Zip Code85364
Applicant7/31/1986 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameOscar Bronze HDHP (HSA-Compatible Plan + Free 24/7 Virtual Visi
Plan IDhhs-13877AZ0070014
Plan Year2021
Insurance ProviderOscar Health Plan, Inc.
Metal LevelExpanded Bronze
Plan TypeHMO
Deductible$5,200
Out-of-Pocket Maximum$7,000
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$50 Copay after deductible
Specialist Visit$90 Copay after deductible
Laboratory Outpatient and Professional Services$50 Copay after deductible
X-rays and Diagnostic Imaging50.00% Coinsurance after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans50.00% Coinsurance after deductible
Deductible - Family$10400 per group
Out-of-Pocket Maximum - Family$14000 per group

Prescription drug coverage

Generic Drugs$3 Copay after deductible
Preferred Brand Drugs$200 Copay after deductible
Non-Preferred Brand Drugs50.00% Coinsurance after deductible
Specialty Drugs50.00% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttps://www.hioscar.com/search
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?Yes - Emergency and Urgent Services only.
Does this plan cover services outside the country?Yes - Emergency Services only.

Hospital services

Emergency Room Services50.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)50.00% Coinsurance after deductible
Inpatient Physician and Surgical Services50.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service50.00% Coinsurance after deductible

Maternity

Prenatal and Postnatal CareNot Applicable
Delivery and all inpatient services for maternity care50.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services$50 Copay after deductible
Mental/Behavioral Health Inpatient Services50.00% Coinsurance after deductible
Substance use disorder outpatient services$50 Copay after deductible
Substance use disorder inpatient services50.00% Coinsurance after deductible

Medical Management Programs

Does this plan offer disease managment programs?Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, 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 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)
Bariatric Surgery
Private-Duty Nursing
Imaging (CT/PET Scans, MRIs)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Habilitation Services
Durable Medical Equipment
Hospice Services
Dental Check-Up for Children
Accidental Dental
Allergy Testing
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 BenefitsPreventive Care/Screening/Immunization
Skilled Nursing Facility
Hearing Aids
Home Health Care Services
Outpatient Rehabilitation Services
Chiropractic Care
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
More Excluded BenefitsAcupuncture
Cosmetic Surgery
Infertility Treatment
Weight Loss Programs
Routine Foot Care
Abortion for Which Public Funding is Prohibited
Long-Term/Custodial Nursing Home Care
PremiumPlan NameDeductible
from $333Oscar Silver Classic Off-Ex$5,000.00Select
from $374Oscar Silver Classic ($3 Prescription List + Free 24/7 Virtual$5,000.00Select
from $412Cigna Connect 5000$5,000.00Select
from $532Ambetter Balanced Care 9 (2021)$5,000.00Select
from $557Ambetter Balanced Care 9 (2021) + Vision + Adult Dental$5,000.00Select
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Rajesh, Khona
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Kita, Patel
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William, Shea
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Timothy, Graham
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Jay, Eldridge
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Donald, Runyan
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Shawn, Hermenau
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Nicolas, Santos
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Nnabuikem, Anaba
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Kailey, Rote
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Joseph, Sanchez
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Michael, Mccullagh
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Zachary, Parkinson
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Shanti Anesthesiology, Pllc
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Nafisah, Naqvi
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Stephanie, Clark
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Mina, Tawadrous
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Lee, Barnwell
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Marjorie, Bacon
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Jennifer, Mccumbee
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James, Lavin
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Kemell Health Llc
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Southwestern Palliative Care Associates Plc
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Rajesh Khona, M.D.
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  • Phone Number
    (602) 273-6770
  • Office Locations
    2400 S Avenue A
    Yuma, AZ 85364
2400 S Avenue A Yuma AZ, 85364

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HealthPocket.com is a free information source. 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. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. While on our site, if you click on a plan or link, you may be directed to one of our partners who offers health insurance products. HealthPocket, Inc. is part of the Benefytt Technologies, Inc. family of companies.