Community HealthEssentials Bronze WA

Plan Information
Company Community Health Plan of Washington
State WA
Metal Tier Bronze
Plan Type PPO

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) $5,000 Data Not Available
Deductible (Family) $10,000 Data Not Available
Coinsurance $0 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 $45 copay Data Not Available
Specialist Visit $75 copay Data Not Available
In Patient Hospital Services $0 Data Not Available
Emergency Room Services $500 copay $500 copay
Mental / Behavioral Health $0 Data Not Available
Imaging (CT/PET Scans, MRIs) $0 Data Not Available
Rehabilitative Speech Therapy $0 Data Not Available
Rehabilitative Occupational & Physical Therapy $0 Data Not Available
Preventative Care $0 Data Not Available
Laboratory Outpatient and Professional Services $0 Data Not Available
X-ray and Diagnostic Imaging $0 Data Not Available
Prescription Drugs In Network Out of Network
Generic Rx $25 copay
Preferred Brand Rx 50% coinsurance
Non Preferred Brand Rx $0
Specialty Drugs 0.5

Other Plans

Other plans that are available in the state.

Plan Name
HealthEssentials Gold
HealthEssentials Silver CSR 94
HealthEssentials Silver CSR 87
HealthEssentials Silver CSR 73
HealthEssentials Silver
HealthEssentials Bronze
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