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Hawaii - HMSA Bronze HMO
Hawaii, 2018
Plan Type
HMO
Metal Tier
Bronze
Out of Pocket Maximum
$7,350
Deductible
$6,000
Call (855) 866-5590 to speak with a licensed agent about a new health plan.
Emergency Room Care: $250 Copay 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) | $6,000 |
|---|---|
| Deductible (Family) | $12,000 |
| Coinsurance | Not applicable |
| Out of Pocket Maximum (Individual) | $7,350 |
| Out of Pocket Maximum (Family) | $14,700 |
Doctor Visits
| Primary Care Visit | $40 Copay after deductible |
|---|---|
| Specialist Visit | $60 Copay after deductible |
| Inpatient Facility | $400 Copay per day after deductible |
| Inpatient Physician | 40% Coinsurance after deductible |
| Emergency Room Services | $250 Copay after deductible |
Tests and Imaging
| Imaging (CT/PET Scans, MRIs) | $400 Copay after deductible |
|---|---|
| Laboratory Outpatient and Professional Services | $40 Copay after deductible |
| X-Ray and Diagnostic Imaging | $40 Copay after deductible |
Health Management Programs
| Asthma | Available |
|---|---|
| Depression | Available |
| Diabetes | Available |
| Heart Disease | Available |
| High Blood Pressure / High Cholesterol | Available |
| Lower Back Pain | Not available |
| Pain Management | Not available |
| Pregnancy | Available |
| Weight Loss | Not available |
Other
| Mental / Behavioral Health Inpatient | No charge after deductible |
|---|---|
| Mental / Behavioral Health Outpatient | 0% Coinsurance after deductible |
| Rehabilitative Speech Therapy | $40 Copay after deductible |
| Rehabilitative Occupational & Physical Therapy | $40 Copay after deductible |
| Outpatient Facility | 40% Coinsurance after deductible |
| Outpatient Surgery | 40% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | Data Not Available |
|---|---|
| Preferred Brand Rx | $50 Copay after deductible |
| Non Preferred Brand Rx | $100 Copay after deductible |
| Specialty Drugs | 20% Coinsurance after deductible |
Other Plans in Hawaii
| Plan | Deductible | Coinsurance | Out of Pocket |
|---|---|---|---|
| Plan HMSA Silver PPO 2000 | Deductible $2,000 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan HMSA Platinum PPO | Deductible $0 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan HMSA Gold PPO | Deductible $0 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan HMSA Bronze PPO 7350 | Deductible $7,350 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan HMSA Gold HMO | Deductible $1,000 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan HMSA Catastrophic Plan | Deductible $7,350 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan HMSA Gold PPO 1000 | Deductible $1,000 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan HMSA Silver PPO 3500 | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan HMSA Platinum HMO | Deductible $0 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan HMSA Silver HMO | Deductible $2,500 | Coinsurance Not applicable | Out of Pocket $7,350 |