2018 ENGAGE LB600-IN18 Plan Details - HealthPocket

ENGAGE LB600-IN18

$448.65/mo

Apply For This Plan

Zip Code33186
Applicant8/14/1983 Male
Coverage Start8/15/2018
Apply Now

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameENGAGE LB600-IN18
Plan IDhhs-19898FL0220006
Insurance ProviderAvMed
Metal LevelExpanded Bronze
Plan TypeHMO
Deductible$6,500
Out-of-Pocket Maximum$7,000
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$85 Copay
Specialist Visit$170 Copay
Laboratory Outpatient and Professional Services$40 Copay
X-rays and Diagnostic Imaging$130 Copay after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans$500 Copay after deductible
Deductible - Family$13000 per group
Out-of-Pocket Maximum - Family$14000 per group

Prescription drug coverage

Generic Drugs$36 Copay
Preferred Brand Drugs$85 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.avmed.org/web/individuals-families
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?Yes - All except OB/Gyn, Chiropractor, and Podiatrist for diabetic foot care.
Does this plan cover services outside plan service area?Yes - Urgent/Emergent Only
Does this plan cover services outside the country?Yes - Urgent/Emergent Only

Hospital services

Emergency Room Services$500 Copay after deductible
Inpatient Hospital Services (e.g., Hospital Stay)$500 Copay per Stay after deductible
Inpatient Physician and Surgical ServicesNo Charge after deductible
Emergency Transportation or Ambulance Service$150 Copay

Maternity

Prenatal and Postnatal Care$85 Copay
Delivery and all inpatient services for maternity care$500 Copay after deductible

Mental Health

Mental/Behavioral Health Outpatient Services$85 Copay
Mental/Behavioral Health Inpatient Services$500 Copay per Stay after deductible
Substance use disorder outpatient services$85 Copay
Substance use disorder inpatient services$500 Copay per Stay after deductible

Medical Management 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)
Preventive Care/Screening/Immunization
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
Durable Medical Equipment
Hospice Services
Routine Foot Care
Non-Emergency Care When Traveling Outside the U.S.
Dental Anesthesia
Diabetes Care Management
Accidental Dental
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
Bone Marrow Transplant
Congenital Anomaly, including Cleft Lip/Palate
Nutrition/Formulas
Off Label Prescription Drugs
Osteoporosis
More Limited BenefitsSkilled Nursing Facility
Home Health Care Services
Outpatient Rehabilitation Services
Habilitation Services
Dental Check-Up for Children
Chiropractic Care
Nutritional Counseling
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
More Excluded BenefitsAcupuncture
Bariatric Surgery
Cosmetic Surgery
Hearing Aids
Infertility Treatment
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Weight Loss Programs
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $216
Ambetter Essential Care 7 (2018)
$6,500.00Select
from $225
IND Bronze Standardized HMO
$6,650.00Select
from $238
Gym Access IND Bronze HMO BC 3841
$6,400.00Select
from $261
Gym Access IND Bronze POS BC 3841
$6,400.00Select
from $270
Health First Bronze HMO 60 1750
$6,650.00Select

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual 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.

Close

Health Plans Found