BridgeSpan - Bronze Essential 7150 EPO OHSU Plus

Oregon, 2018

  • Plan Type

    EPO

  • Metal Tier

    Bronze

  • Out of Pocket Maximum

    $7,350

  • Deductible

    $7,150

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

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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) $7,350
Out of Pocket Maximum (Family) $14,700

Doctor Visits

Primary Care Visit $60 Copay after deductible + 10% Coinsurance after deductible
Specialist Visit $60 Copay after deductible + 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 Not 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 10% Coinsurance after deductible
Non Preferred Brand Rx 50% Coinsurance after deductible
Specialty Drugs 40% Coinsurance after deductible

Other Plans in Oregon

Plan BridgeSpan Standard Silver Plan OHSU Plus Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan BridgeSpan Standard Gold Plan OHSU Plus Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,850
Plan Bronze HDHP 6000 EPO OHSU Plus Deductible $6,000 Coinsurance Not applicable Out of Pocket $6,650
Plan Silver HDHP 3000 EPO OHSU Plus Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,650
Plan BridgeSpan Standard Bronze HSA Plan OHSU Plus Deductible $6,550 Coinsurance Not applicable Out of Pocket $6,550
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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) $7,350
Out of Pocket Maximum (Family) $14,700

Doctor Visits

Primary Care Visit $60 Copay after deductible + 10% Coinsurance after deductible
Specialist Visit $60 Copay after deductible + 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 Not 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 10% Coinsurance after deductible
Non Preferred Brand Rx 50% Coinsurance after deductible
Specialty Drugs 40% Coinsurance after deductible

Other Plans in Oregon

Plan BridgeSpan Standard Silver Plan OHSU Plus Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan BridgeSpan Standard Gold Plan OHSU Plus Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,850
Plan Bronze HDHP 6000 EPO OHSU Plus Deductible $6,000 Coinsurance Not applicable Out of Pocket $6,650
Plan Silver HDHP 3000 EPO OHSU Plus Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,650
Plan BridgeSpan Standard Bronze HSA Plan OHSU Plus Deductible $6,550 Coinsurance Not applicable Out of Pocket $6,550