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UPMC - UPMC Advantage Catastrophic $7,150/$0 – Select Network
Pennsylvania, 2017
Plan Type
EPO
Metal Tier
Catastrophic
Out of Pocket Maximum
$7,150
Deductible
$7,150
Emergency Room Care: No charge after deductible
Cost Sharing Benefits (In Network)
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.
| Deductible (Individual) | $7,150 |
|---|---|
| Deductible (Family) | $14,300 |
| Coinsurance | Not applicable |
| Out of Pocket Maximum (Individual) | $7,150 |
| Out of Pocket Maximum (Family) | $14,300 |
Doctor Visits
| Primary Care Visit | No charge after deductible |
|---|---|
| Specialist Visit | No charge after deductible |
| Inpatient Facility | No charge after deductible |
| Inpatient Physician | No charge after deductible |
| Emergency Room Services | No charge after deductible |
Tests and Imaging
| Imaging (CT/PET Scans, MRIs) | No charge after deductible |
|---|---|
| Laboratory Outpatient and Professional Services | No charge after deductible |
| X-Ray and Diagnostic Imaging | No charge after deductible |
Health Management Programs
| Asthma | Available |
|---|---|
| Depression | Available |
| Diabetes | Available |
| Heart Disease | Available |
| High Blood Pressure / High Cholesterol | Available |
| Lower Back Pain | Available |
| Pain Management | Available |
| Pregnancy | Available |
| Weight Loss | Not available |
Other
| Mental / Behavioral Health Inpatient | No charge after deductible |
|---|---|
| Mental / Behavioral Health Outpatient | No charge after deductible |
| Rehabilitative Speech Therapy | No charge after deductible |
| Rehabilitative Occupational & Physical Therapy | No charge after deductible |
| Outpatient Facility | No charge after deductible |
| Outpatient Surgery | No charge after deductible |
Prescription Drugs
| Generic Rx | No charge after deductible |
|---|---|
| Preferred Brand Rx | No charge after deductible |
| Non Preferred Brand Rx | No charge after deductible |
| Specialty Drugs | No charge after deductible |
Other Plans in Pennsylvania
| Plan | Deductible | Coinsurance | Out of Pocket |
|---|---|---|---|
| Plan UPMC Advantage Silver HSA $2,600/20% - Partner Network | Deductible $2,600 | Coinsurance Not applicable | Out of Pocket $4,100 |
| Plan UPMC Advantage Platinum $250/$20 - Select Network | Deductible $250 | Coinsurance Not applicable | Out of Pocket $1,500 |
| Plan UPMC Advantage Silver $0/$50 - Premium Network | Deductible $0 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Gold $750/$10 - Select Network | Deductible $750 | Coinsurance Not applicable | Out of Pocket $3,500 |
| Plan UPMC Advantage Silver $1,750/$30 - Partner Network | Deductible $1,750 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Silver $3,500/$30 - Partner Network | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Silver HSA $2,600/20% - Premium Network | Deductible $2,600 | Coinsurance Not applicable | Out of Pocket $4,100 |
| Plan UPMC Advantage Silver $3,500/$30 - Select Network | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Silver HSA $2,600/20% - Select Network | Deductible $2,600 | Coinsurance Not applicable | Out of Pocket $4,100 |
| Plan UPMC Advantage Gold $750/$10 - Premium Network | Deductible $750 | Coinsurance Not applicable | Out of Pocket $3,500 |
| Plan UPMC Advantage Bronze $6,950/$35 – Premium Network | Deductible $6,950 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Silver $0/$50 - Partner Network | Deductible $0 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Silver $1,750/$30 - Premium Network | Deductible $1,750 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Silver $0/$50 - Select Network | Deductible $0 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Silver $3,250/$10 - Partner Network | Deductible $3,250 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Gold $750/$10 - Partner Network | Deductible $750 | Coinsurance Not applicable | Out of Pocket $3,500 |
| Plan UPMC Advantage Silver $1,750/$30 - Select Network | Deductible $1,750 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Bronze $6,950/$35 – Partner Network | Deductible $6,950 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Platinum $250/$20 - Premium Network | Deductible $250 | Coinsurance Not applicable | Out of Pocket $1,500 |
| Plan UPMC Advantage Catastrophic $7,150/$0 - Premium Network | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Catastrophic $7,150/$0 - Partner Network | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Silver $3,250/$10 - Premium Network | Deductible $3,250 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Silver $3,500/$30 - Premium Network | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Silver $3,250/$10 - Select Network | Deductible $3,250 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Bronze $6,950/$35 – Select Network | Deductible $6,950 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan UPMC Advantage Platinum $250/$20 - Partner Network | Deductible $250 | Coinsurance Not applicable | Out of Pocket $1,500 |