2018 Medica Insure Bronze HSA Plus Plan Details - HealthPocket

Medica Insure Bronze HSA Plus


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Zip Code50317
Applicant8/21/1983 Male
Coverage Start8/22/2018
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameMedica Insure Bronze HSA Plus
Plan IDqhp-93078IA0010023
Insurance ProviderMedica
Metal LevelExpanded Bronze
Plan TypePPO
Out-of-Pocket Maximum$6,650
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness40% Coinsurance after deductible
Specialist Visit40% Coinsurance after deductible
Deductible - Family$5200
Out-of-Pocket Maximum - Family$13300

Prescription drug coverage

Generic Drugs40% Coinsurance after deductible
Preferred Brand Drugs40% Coinsurance after deductible
Non-Preferred Brand Drugs40% Coinsurance after deductible
Specialty Drugs30% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLComing Soon

Hospital services

Emergency Room Services40% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)40% Coinsurance after deductible
Inpatient Physician and Surgical Services40% Coinsurance after deductible
PremiumPlan NameDeductible
from $66
LifeShield Flex 2500/20/6500/750000
from $67
LifeShield Flex 2500/20/5500/750000
from $67
LifeShield Flex 2500/20/6500/1000000
from $68
LifeShield Flex 2500/20/4500/750000
from $69
LifeShield Flex 2500/20/5500/1000000

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