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
Outpatient Facility $0 Data Not Available
Outpatient Surgery $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
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