Insurance Type | ACA (Obamacare) |
Plan Name | Horizon Advantage EPO Essentials |
Plan ID | qhp-91661NJ2280001 |
Plan Year | 2019 |
Insurance Provider | Horizon Blue Cross Blue Shield of New Jersey |
Metal Level | Catastrophic |
Plan Type | EPO |
Deductible | $7,900 |
Out-of-Pocket Maximum | $7,900 |
Personal Score | |
Plan Highlights |
Costs for Medical Care | |
---|---|
Primary Care Visit to Treat an Injury or Illness | No Charge after Deductible |
Specialist Visit | No Charge after Deductible |
Laboratory Outpatient and Professional Services | No Charge after deductible |
X-rays and Diagnostic Imaging | No Charge after deductible |
Deductible - Family | $15800 |
Out-of-Pocket Maximum - Family | $15800 |
Prescription drug coverage | |
---|---|
Generic Drugs | No Charge after Deductible |
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 | Coming Soon |
Hospital services | |
---|---|
Emergency Room Services | No Charge after Deductible |
Inpatient Hospital Services (e.g., Hospital Stay) | No Charge after Deductible |
Inpatient Physician and Surgical Services | No Charge after Deductible |
Maternity | |
---|---|
Prenatal and Postnatal 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 |
Vision Coverage | |
---|---|
Routine Eye Exam for Children | No Charge |
Eye Glasses for Children | No Charge |
Exclusions and Limitations | |
---|---|
More Included Benefits | Accidental Dental Dialysis Allergy Testing Chemotherapy Radiation Diabetes Education Prosthetic Devices Other Practitioner Office Visit (Nurse, Physician Assistant) Outpatient Facility Fee (e.g., Ambulatory Surgery Center) Outpatient Surgery Physician/Surgical Services Hospice Services Infertility Treatment Urgent Care Centers or Facilities Home Health Care Services Inpatient 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 Rehabilitative Speech Therapy Rehabilitative Occupational and Rehabilitative Physical Therapy Well Baby Visits and Care Abortion for Which Public Funding is Prohibited Transplant Infusion Therapy Treatment for Temporomandibular Joint Disorders Nutritional Counseling Reconstructive Surgery |
More Excluded Benefits | Long-Term/Custodial Nursing Home Care Private-Duty Nursing Cosmetic Surgery Routine Foot Care Acupuncture Weight Loss Programs Dental Check-Up for Children |
Catastrophic health insurance is a type of medical coverage under the Affordable Care Act. This is a type of high-deductible health plan for people under 30 or those who qualify for a "hardship exemption."
The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. There is no actuarial value associated with catastrophic plans but other Obamacare metal plans pay a higher percentage of these costs.
The monthly premium for a Catastrophic Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and the region in which you live. You can use HealthPocket’s comparison tool to compare Catastrophic Plan premiums in your area.
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.
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.