Coventry Bronze $10 Copay POS UnityPoint Health IA

Plan Information
Company Coventry Health Care of Iowa Inc.
State IA
Metal Tier Bronze
Plan Type POS

Cost Sharing Benefits

Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $5,600 Data Not Available
Deductible (Family) $11,200 Data Not Available
Coinsurance Data Not Available Data Not Available
Out of Pocket Maximum (Individual) $6,350 Data Not Available
Out of Pocket Maximum (Family) $12,700 Data Not Available
Services In Network Out of Network
Primary Care Visit $10 Data Not Available
Specialist Visit $75 Copay before deductible Data Not Available
In Patient Hospital Services $500 Copay per Stay and 30% Coin Data Not Available
Emergency Room Services $500 Copay before deductible Data Not Available
Mental / Behavioral Health Data Not Available Data Not Available
Imaging (CT/PET Scans, MRIs) Data Not Available Data Not Available
Rehabilitative Speech Therapy Data Not Available Data Not Available
Rehabilitative Occupational & Physical Therapy Data Not Available Data Not Available
Preventative Care Data Not Available Data Not Available
Laboratory Outpatient and Professional Services Data Not Available Data Not Available
X-ray and Diagnostic Imaging Data Not Available Data Not Available
Outpatient Facility Data Not Available Data Not Available
Outpatient Surgery Data Not Available Data Not Available
Prescription Drugs In Network Out of Network
Generic Rx $15
Preferred Brand Rx $45 Copay after deductible
Non Preferred Brand Rx $75 Copay after deductible
Specialty Drugs 30% Coinsurance after deductible

Other Plans

Other plans that are available in the state.

Plan Name
Coventry Gold $5 Copay Methodist Health Partners
Coventry Silver $10 Copay Methodist Health Partners
Coventry Bronze $20 Copay Methodist Health Partners
Coventry Bronze Deductible Only HSA Eligible Methodist Health Partners
Coventry Silver $5 Copay 2750 Methodist Health Partners
Coventry Gold $5 Copay MIPPA
Coventry Silver $10 Copay MIPPA
Coventry Bronze $20 Copay MIPPA
Coventry Bronze Deductible Only HSA Eligible MIPPA
Coventry Silver $5 Copay 2750 MIPPA
Coventry Gold $5 Copay Alegent Creighton Health
Coventry Silver $10 Copay Alegent Creighton Health
Coventry Bronze $20 Copay Alegent Creighton Health
Coventry Bronze Deductible Only HSA Eligible Alegent Creighton Health
Coventry Silver $5 Copay 2750 Alegent Creighton Health
Coventry Gold $5 Copay Patient Preferred
Coventry Silver $10 Copay Patient Preferred
Coventry Bronze $20 Copay Patient Preferred
Coventry Bronze Deductible Only HSA Eligible Patient Preferred
Coventry Silver $5 Copay 2750 Patient Preferred
Coventry Bronze $20 Copay UnityPoint Health Des Moines
Coventry Bronze Deductible Only HSA Eligible UnityPoint Health Des Moines
Coventry Gold $5 Copay UnityPoint Health Des Moines
Coventry Silver $10 Copay UnityPoint Health Des Moines
Coventry Silver $5 Copay 2750 UnityPoint Health Des Moines
Coventry Bronze $20 Copay UnityPoint Health Cedar Rapids
Coventry Bronze $20 Copay UnityPoint Health Quad Cities Muscatine
Coventry Bronze $20 Copay UnityPoint Health Waterloo
Coventry Bronze Deductible Only HSA Eligible UnityPoint Health Cedar Rapids
Coventry Bronze Deductible Only HSA Eligible UnityPoint Health Quad Cities Muscatine
Coventry Bronze Deductible Only HSA Eligible UnityPoint Health Waterloo
Coventry Gold $5 Copay UnityPoint Health Cedar Rapids
Coventry Gold $5 Copay UnityPoint Health Quad Cities Muscatine
Coventry Gold $5 Copay UnityPoint Health Waterloo
Coventry Silver $10 Copay UnityPoint Health Cedar Rapids
Coventry Silver $10 Copay UnityPoint Health Quad Cities Muscatine
Coventry Silver $10 Copay UnityPoint Health Waterloo
Coventry Silver $5 Copay 2750 UnityPoint Health Cedar Rapids
Coventry Silver $5 Copay 2750 UnityPoint Health Quad Cities Muscatine
Coventry Silver $5 Copay 2750 UnityPoint Health Waterloo
Coventry Gold $5 Copay
Coventry Silver $10 Copay
Coventry Bronze $20 Copay
Coventry Bronze Deductible Only HSA Eligible
Coventry Bronze $20 Copay Mercy Des Moines
Coventry Bronze Deductible Only HSA Eligible Mercy Des Moines
Coventry Gold $5 Copay Mercy Des Moines
Coventry Marketplace Choice Plan
Coventry Silver $10 Copay Mercy Des Moines
Coventry Silver $5 Copay 2750
Coventry Silver $5 Copay 2750 Mercy Des Moines
Coventry Bronze $20 Copay Accountable Care Alliance
Coventry Bronze Deductible Only HSA Eligible Accountable Care Alliance
Coventry Gold $5 Copay Accountable Care Alliance
Coventry Silver $10 Copay Accountable Care Alliance
Coventry Silver $5 Copay 2750 Accountable Care Alliance
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