2019 HMO 3800 Methodist Bronze Plan Details - HealthPocket

HMO 3800 Methodist Bronze

$358.21/mo

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Zip Code60629
Applicant12/14/1983 Male
Coverage Start12/15/2018
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameHMO 3800 Methodist Bronze
Plan IDqhp-20129IL0330064
Plan Year2019
Insurance ProviderHealth Alliance
Metal LevelExpanded Bronze
Plan TypeHMO
Deductible$3,800
Out-of-Pocket Maximum$7,900
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness50% Coinsurance after deductible
Specialist Visit50% Coinsurance after deductible
Laboratory Outpatient and Professional Services0.00%
X-rays and Diagnostic Imaging0.00%
Deductible - Family$7600
Out-of-Pocket Maximum - Family$15800

Prescription drug coverage

Generic Drugs$10 Copay
Preferred Brand Drugs$40 Copay
Non-Preferred Brand Drugs$80 Copay
Specialty Drugs50% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLComing Soon

Hospital services

Emergency Room Services50% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)50% Coinsurance after deductible
Inpatient Physician and Surgical Services50% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care0.00%

Mental Health

Mental/Behavioral Health Outpatient Services0.00%
Mental/Behavioral Health Inpatient Services0.00%

Vision Coverage

Routine Eye Exam for Children0.00%
Eye Glasses for Children0.00%

Exclusions and Limitations

More Included BenefitsInpatient Physician and Surgical Services
Bariatric Surgery
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Durable Medical Equipment
Hearing Aids
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Routine Foot Care
Dental Check-Up for Children
Rehabilitative Speech Therapy
Rehabilitative Occupational and Rehabilitative Physical Therapy
Well Baby Visits and Care
Transplant
Accidental Dental
Dialysis
Allergy Testing
Chemotherapy
Radiation
Diabetes Education
Prosthetic Devices
Infusion Therapy
Treatment for Temporomandibular Joint Disorders
Nutritional Counseling
Reconstructive Surgery
Other Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Infertility Treatment
Private-Duty Nursing
Urgent Care Centers or Facilities
Home Health Care Services
More Excluded BenefitsCosmetic Surgery
Acupuncture
Weight Loss Programs
Abortion for Which Public Funding is Prohibited
Long-Term/Custodial Nursing Home Care
PremiumPlan NameDeductible
from $375
HMO 3800 Elite Bronze
$3,800.00Select
from $383
HMO 3800 OSF Bronze
$3,800.00Select
from $428
HMO 3800 Methodist Bronze
$3,800.00Select
from $443
Performance Silver 4000 - Copay $45/$90
$4,000.00Select
from $459
HMO 3800 OSF Bronze
$3,800.00Select
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  • Phone Number
    (773) 884-1662
  • Office Locations
    2701 W 68th St
    Chicago, IL 60629
2701 W 68th St Chicago IL, 60629

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.

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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.