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Summary Of Benefits And Coverages (PDF).pdf

expandedbronze.pdf

Preview of Summary of benefits and coverages (PDF)

🔗 Source: doc.uhealthplan.utah.edu

📊 Size: 322 KB

👤 Author: Abhishek Singh

⬇️ Downloads: 150

Summary

Healthy Premier Expanded Bronze, Coverage Period: 01/01/2024 – 12/31/2024, has the following key features:
- Overall deductible: $8,000/Individual, $16,000/Family
- Services covered before deductible: Preventive care, office visits, and prescription drugs
- Additional deductibles: $3,000/individual or $6,000/family for prescription drugs
- Out-of-pocket limit: $9,100/Individual, $18,200/Family
- Network providers: Using in-network providers results in lower costs
- Referrals: No referral needed to see a specialist
- Costs for common medical events:
- Primary care visit: $50 copay
- Specialist visit: $80 copay
- Preventive care: No charge
- Diagnostic tests: 50% coinsurance
- Prescription drugs: Copays or coinsurance vary by tier
- Outpatient surgery: 50% coinsurance
- Emergency room care: 50% coinsurance
- Hospital stay: 50% coinsurance
- Mental health services: $50 copay or 50% coinsurance
- Pregnancy care: 50% coinsurance

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Description

Healthy Premier Expanded Bronze, Coverage Period: 01/01/2024 – 12/31/2024, has the following key features:
- Overall deductible: $8,000/Individual,...

Technical Information

File Format: PDF
File Size: 322 KB
Pages: 7
Language: EN
Author: Abhishek Singh
Total Downloads: 150
Last Updated: 1 week ago

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