Bronze Bronze 60 HDHP

High Deductible Health Plan with HSA eligibility

Cost Overview

Annual Deductible

$6,850

Out-of-Pocket Maximum

$6,850

Standardized Benefits

Service You Pay Notes
Deductibles
Individual Deductible (Medical) $6,850
Individual Deductible (Pharmacy) integrated medical and pharmacy deductible
Family Deductible (Medical) $13,700
Family Deductible (Pharmacy) integrated medical and pharmacy deductible
Care Visits
Preventive Care 0% No deductible
Primary Care Visit 0% Deductible may apply
Urgent Care Visit 0%
Specialty Care Visit 0% Deductible may apply
Mental/Behavioral Health Visit 0%
Tests & Therapy
Other Therapy (PT/OT/Speech) 0%
Lab Testing 0%
X-rays & Diagnostic Imaging 0%
Advanced Imaging (CT/MRI) 0%
Hospital & Emergency
Outpatient Surgery 0% After deductible
Emergency Room 0% After deductible
Emergency Transport 0%
Prenatal/Postnatal Care 0%
Inpatient Hospital Stay 0% After deductible
Hospital Physician 0%
Prescription Drugs
Generic Drugs (Tier 1) 0%
Preferred Brand Drugs (Tier 2) 0%
Non-Preferred Brand Drugs (Tier 3) 0%
Specialty Drugs (Tier 4) 0%
Out of Pocket Maximums
Maximum Out of Pocket (Individual) $6,850 Annual limit
Maximum Out of Pocket (Family) $13,700 Annual limit
Understanding Your Benefits
  • Copay: A fixed amount you pay for a covered service.
  • Coinsurance: Your share of costs after meeting your deductible (shown as a percentage).
  • Deductible: The amount you pay before your insurance starts covering costs.
  • Out-of-Pocket Maximum: The most you'll pay in a year for covered services.