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Mark Jasinski December 5, 2013 at 12:51 pm
Did you include co-pays, co-insurance, deductibles, and out-of-pocket expenses in the monthly cost?Read More Here's the lowest (bronze) policy we qualify for on the Washington exchange. Our family out-of-pocket max is $12,700. That's over $1000 a month. The three figures after each category are "Preferred," "In Network," and "Out of Network." Our provider is considered "In Network." *Plan Summary. All plans include preventive care services at no-cost (including periodic health exams, OB-GYN exam, well baby visit, immunizations, etc.). *Coverage Summary. Community HealthEssentials Bronze. 1. Preferred Network. 2. In Network. 3. Out of Network. *Monthly Premium $769.44. *Your Health Care Provider In Network. *Quality Improvement Strategy. *Pediatric Quality Improvement Strategy. *Plan Type Preferred Provider Organization (PPO). *Plan Metal Level BRONZE . *Out of Pocket Costs: *Annual Deductible: 1. $5,000 Individual / $10,000 Family; 2. $5,000 Individual / $10,000 Family; 3. $5,000 Individual / $10,000 Family. *Annual Out of Pocket Maximum: $6,350 Individual / $12,700 Family; $6,350 Individual / $12,700 Family; Unlimited. *Office Visit for Primary: Care $45 Copay 0% Coinsurance; $45 Copay; 0% Coinsurance; $0 Copay 50% Coinsurance after deductible. *Office Visit for Specialist: $75 Copay 0% Coinsurance; $75 Copay 0% Coinsurance; $0 Copay 50% Coinsurance after deductible. *Prescription Drug Deductible: Included in Annual Deductible; Included in Annual Deductible; Included in Annual Deductible. *Emergency Room: $500 Copay after deductible 0% Coinsurance; $500 Copay after deductible 0% Coinsurance; $500 Copay after deductible 0% Coinsurance. *Out Patient Lab/X-ray: $0 Copay 0% Coinsurance after deductible; $0 Copay 0% Coinsurance after deductible; $0 Copay 50% Coinsurance after deductible. *Out Patient Surgery: $0 Copay 0% Coinsurance after deductible; $0 Copay 0% Coinsurance after deductible; $0 Copay 50% Coinsurance after deductible. *Hospitalization: $0 Copay per Day 0% Coinsurance after deductible; $0 Copay per Day 0% Coinsurance after deductible; $0 Copay per Day 50% Coinsurance after deductible. *Lifetime Maximum: Unlimited; Unlimited; Unlimited. *Health Savings Account Eligible: NO; NO; NO. *Optional Benefits: Out of Country Coverage: NO; NO; NO. Primary Care Physician Required: NO; NO; NO. Specialist Referrals Required: NO; NO; NO. *Chiropractic Coverage: $0 Copay 0% Coinsurance after deductible 10 Visit(s) per Year; $0 Copay 0% Coinsurance after deductible 10 Visit(s) per Year; $0 Copay 50% Coinsurance after deductible 10 Visit(s) per year. *Outpatient Mental Health Coverage: $0 Copay 0% Coinsurance after deductible; $0 Copay 0% Coinsurance after deductible; $0 Copay; 50% Coinsurance after deductible. *Vision Care: Pediatric Only; Pediatric Only; Pediatric Only. *Prescription Pricing: Generic Prescription Drugs: $25 Copay 0% Coinsurance; $25 Copay 0% Coinsurance; $0 Copay 100% Coinsurance. *Brand Prescription Drugs: $0 Copay 50% Coinsurance after deductible; $0 Copay 50% Coinsurance after deductible; $0 Copay 100% Coinsurance. *Additional Benefits: See attached plan document for additional benefits. *Services Not Covered: Bariatric Surgery Cosmetic Surgery Dental Care Adult Infertility Treatment Non-Emergency Care Outside US Private Duty Nursing Routine Eye Care Adult