UPMC - UPMC Advantage Platinum $250/$20 - Partner Network

Pennsylvania, 2017

  • Plan Type

    EPO

  • Metal Tier

    Platinum

  • Out of Pocket Maximum

    $1,500

  • Deductible

    $250

Enroll Now
{"state":{"code":"PA","name":"Pennsylvania","fips":42,"exchangeName":["Healthcare.gov"],"exchangeUrl":["http:\/\/www.healthcare.gov"],"exchangeType":["Federal"]},"year":"2017","plan":{"name":"UPMC - UPMC Advantage Platinum $250\/$20 - Partner Network","planType":"EPO","tier":"Platinum","oopm":"1500.00","deductible":"250.00","redirectUrl":"https:\/\/www.healthcare.gov"},"phoneNum":"8558665590"}

Call (855) 866-5590 to speak with a licensed agent about a new health plan.

{"onCurrent":true}

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) $250
Deductible (Family) $500
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $1,500
Out of Pocket Maximum (Family) $3,000

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit 10% Coinsurance after deductible
Inpatient Facility 10% Coinsurance after deductible
Inpatient Physician 10% Coinsurance after deductible
Emergency Room Services 10% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 10% Coinsurance after deductible
Laboratory Outpatient and Professional Services 10% Coinsurance after deductible
X-Ray and Diagnostic Imaging 10% Coinsurance 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 10% Coinsurance after deductible
Mental / Behavioral Health Outpatient 10% Coinsurance after deductible
Rehabilitative Speech Therapy 10% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 10% Coinsurance after deductible
Outpatient Facility 10% Coinsurance after deductible
Outpatient Surgery 10% Coinsurance after deductible

Prescription Drugs

Generic Rx Data Not Available
Preferred Brand Rx Data Not Available
Non Preferred Brand Rx Data Not Available
Specialty Drugs 50% Coinsurance after deductible

Other Plans in Pennsylvania

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 Catastrophic $7,150/$0 – Select Network Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
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
{"onCurrent":true,"type":"tools"}

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) $250
Deductible (Family) $500
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $1,500
Out of Pocket Maximum (Family) $3,000

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit 10% Coinsurance after deductible
Inpatient Facility 10% Coinsurance after deductible
Inpatient Physician 10% Coinsurance after deductible
Emergency Room Services 10% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 10% Coinsurance after deductible
Laboratory Outpatient and Professional Services 10% Coinsurance after deductible
X-Ray and Diagnostic Imaging 10% Coinsurance 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 10% Coinsurance after deductible
Mental / Behavioral Health Outpatient 10% Coinsurance after deductible
Rehabilitative Speech Therapy 10% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 10% Coinsurance after deductible
Outpatient Facility 10% Coinsurance after deductible
Outpatient Surgery 10% Coinsurance after deductible

Prescription Drugs

Generic Rx Data Not Available
Preferred Brand Rx Data Not Available
Non Preferred Brand Rx Data Not Available
Specialty Drugs 50% Coinsurance after deductible

Other Plans in Pennsylvania

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 Catastrophic $7,150/$0 – Select Network Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
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