2018 Molina Marketplace Bronze Plan Details - HealthPocket

Molina Marketplace Bronze

$202.21/mo

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Zip Code87121
Applicant10/21/1983 Male
Coverage Start10/22/2018
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameMolina Marketplace Bronze
Plan IDqhp-19722NM0010003
Plan Year2018
Insurance ProviderMolina Healthcare
Metal LevelExpanded Bronze
Plan TypeHMO
Deductible$6,400
Out-of-Pocket Maximum$7,350
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$35 Copay
Specialist Visit$80 Copay
Deductible - Family$12800
Out-of-Pocket Maximum - Family$14700

Prescription drug coverage

Generic Drugs$20 Copay
Preferred Brand Drugs$60 Copay
Non-Preferred Brand Drugs50% Coinsurance after deductible
Specialty Drugs50% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLComing Soon

Hospital services

Emergency Room Services$400 Copay
Inpatient Hospital Services (e.g., Hospital Stay)40% Coinsurance after deductible
Inpatient Physician and Surgical Services40% Coinsurance after deductible

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