SelectHealth Value Expanded Bronze 6950 HSA Qualified Plan Details for 2021- HealthPocket

ZIP Code
County
Applicant Info
Applicant
Date of birth
//
Gender
male
female
Income
$

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Zip Code	89110 (edit)
Applicant	8/8/1987 Male (edit)

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Insurance Type	ACA (Obamacare)
Plan Name	SelectHealth Value Expanded Bronze 6950 HSA Qualified
Plan ID	hhs-84445NV0030005
Plan Year	2021
Insurance Provider	SelectHealth
Metal Level	Expanded Bronze
Plan Type	HMO
Deductible	$6,950
Out-of-Pocket Maximum	$6,950
Plan Highlights

Costs for Medical Care
Primary Care Visit to Treat an Injury or Illness	Not Applicable
Specialist Visit	Not Applicable
Laboratory Outpatient and Professional Services	No Charge after deductible
X-rays and Diagnostic Imaging	No Charge after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans	No Charge after deductible
Deductible - Family	$13900 per group
Out-of-Pocket Maximum - Family	$13900 per group

Prescription drug coverage
Generic Drugs	Not Applicable
Preferred Brand Drugs	No Charge after deductible
Non-Preferred Brand Drugs	No Charge after deductible
Specialty Drugs	No Charge after deductible

Access to doctors and hospitals
Provider directory URL	http://selecthealth.org/find-a-doctor
Does this plan have access to a national provider network?	No
Is a referral required to see a Specialist?	Yes - Except for general ophthalmology, gynecological and obstetrical, general podiatry, mental health and substance abuse, services received from a Secondary Care Provider or ancillary Provider require a referral from your Primary Care Provider.
Does this plan cover services outside plan service area?	No - Urgent or Emergency Care Only
Does this plan cover services outside the country?	No - Urgent or Emergency Care Only

Hospital services
Emergency Room Services	Not Applicable
Inpatient Hospital Services (e.g., Hospital Stay)	No Charge after deductible
Inpatient Physician and Surgical Services	No Charge after deductible
Emergency Transportation or Ambulance Service	No Charge after deductible

Maternity
Prenatal and Postnatal Care	No Charge after deductible
Delivery and all inpatient services for maternity care	No Charge after deductible

Mental Health
Mental/Behavioral Health Outpatient Services	No Charge after deductible
Mental/Behavioral Health Inpatient Services	No Charge after deductible
Substance use disorder outpatient services	No Charge after deductible
Substance use disorder inpatient services	No Charge 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?	Covered

Vision Coverage
Routine Eye Exam for Children	Covered
Eye Glasses for Children	Covered
Routine Eye Exam for Adults	Not Covered

Child Dental Coverage
Child Dental Coverage - Routine Dental Care	Not Covered
Child Dental Coverage - Basic Dental Care	Not Covered
Child Dental Coverage - Orthodontia	Not Covered
Child Dental Coverage - Major Dental Care	Not Covered

Adult Dental Coverage
Adult Dental Coverage - Routine Dental Care	Not Covered
Adult Dental Coverage - Basic Dental Care	Not Covered
Adult Dental Coverage - Orthodontia	Not Covered
Adult Dental Coverage - Major Dental Care	Not Covered

Exclusions and Limitations
More Included Benefits	Other Practitioner Office Visit (Nurse, Physician Assistant) Preventive Care/Screening/Immunization Private-Duty Nursing Imaging (CT/PET Scans, MRIs) Outpatient Surgery Physician/Surgical Services Urgent Care Centers or Facilities Inpatient Physician and Surgical Services Home Health Care Services 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 Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
More Limited Benefits	Skilled Nursing Facility Bariatric Surgery Hearing Aids Infertility Treatment Outpatient Rehabilitation Services Habilitation Services Durable Medical Equipment Hospice Services Chiropractic Care Nutritional Counseling Prosthetic Devices Rehabilitative Occupational and Rehabilitative Physical Therapy Rehabilitative Speech Therapy
More Excluded Benefits	Acupuncture Cosmetic Surgery Weight Loss Programs Dental Check-Up for Children Routine Foot Care Abortion for Which Public Funding is Prohibited Long-Term/Custodial Nursing Home Care

+ See All Coverage Details

Premium	Plan Name	Deductible
from $267	SelectHealth Value Expanded Bronze 7000 - no deductible for urgent care and PCP office visits	$7,000.00	Select
from $290	MySHL Solutions EPO Bronze 13	$6,900.00	Select
from $300	MyHPN Plus Bronze 6	$6,900.00	Select
from $308	SelectHealth Value Expanded Bronze 6900 - no deductible for urgent care and PCP office visits	$6,900.00	Select
from $309	Anthem Bronze Pathway Guided Access HMO 7000 for HSA	$7,000.00	Select

Last Name

Location/Distance

Please select the correct zip

Carlos, Ezpeleta

Ahmad, Saab

Richard, Orr

Chris, Nurre

Olivia, Yuson

Stephanneth, Adams

Rahul, Sharma

Paola, Diaz

Anais, Rodriguez

Anyi, Sepulveda

Thelma, Durbin

Jessica, Sanabria

Binh, Nguyen

New Mind Primary Care Clinic

Ronualdo, Robina

Kallee, Oxborrow

Logan, Klahn

Octavia, Maufas

Joseph, Santos

Elizabeth, Chapa

Laura, Girgash

Carlos Ezpeleta, M.D.

View All Details

Phone Number
(702) 383-6250
Office Locations
61 N. Nellis Blvd.
Las Vegas, NV 89110

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ZIP Code
County
Applicant Info
Applicant
Date of birth
//
Gender
male
female
Income
$

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SelectHealth Value Expanded Bronze 6950 HSA Qualified

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Benefits & Coverage

Costs for Medical Care

Prescription drug coverage

Access to doctors and hospitals

Hospital services

Maternity

Mental Health

Medical Management Programs

Vision Coverage

Child Dental Coverage

Adult Dental Coverage

Exclusions and Limitations

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SelectHealth Value Expanded Bronze 6950 HSA Qualified

Apply For This Plan

Benefits & Coverage

Costs for Medical Care

Prescription drug coverage

Access to doctors and hospitals

Hospital services

Maternity

Mental Health

Medical Management Programs

Vision Coverage

Child Dental Coverage

Adult Dental Coverage

Exclusions and Limitations

Similar Plans

Physician Finder

Related Articles

Related Searches

Apply For This Plan

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