UPMC - UPMC Advantage Gold $800/$20 - Select Network

Pennsylvania, 2018

  • Plan Type

    EPO

  • Metal Tier

    Gold

  • Out of Pocket Maximum

    $5,000

  • Deductible

    $800

Enroll Now
{"state":{"code":"PA","name":"Pennsylvania","fips":42,"exchangeName":["Healthcare.gov"],"exchangeUrl":["http:\/\/www.healthcare.gov"],"exchangeType":["Federal"]},"year":"2018","plan":{"name":"UPMC - UPMC Advantage Gold $800\/$20 - Select Network","planType":"EPO","tier":"Gold","oopm":"5000.00","deductible":"800.00","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) $800
Deductible (Family) $1,600
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $5,000
Out of Pocket Maximum (Family) $10,000

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
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 Data Not Available
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 Data Not Available
Rehabilitative Speech Therapy Data Not Available
Rehabilitative Occupational & Physical Therapy Data Not Available
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

Other Plans in Pennsylvania

Plan UPMC Advantage Silver $3,500/$25 - Partner Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Inside Advantage for Individuals Platinum $250/$20 - Premium Network Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
Plan UPMC Advantage Silver $1,750/$50 - Premium Network Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Inside Advantage for Individuals Silver $0/$50 - Premium Network Deductible $0 Coinsurance Not applicable Out of Pocket $7,350
Plan Tower UPMC Advantage Bronze $6,950/$35 - Tower Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Silver $0/$50 - Select Network Deductible $0 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Silver $0/$50 - Partner Network Deductible $0 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Gold $1,400/$20 - Premium Network Deductible $1,400 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Gold $1,400/$20 - Select Network Deductible $1,400 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Bronze $6,950/$35 - Premium Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Gold $800/$20 - Premium Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Silver HSA $2,700/20% - Select Network Deductible $2,700 Coinsurance Not applicable Out of Pocket $4,300
Plan UPMC Advantage Silver $3,500/$30 - Select Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Catastrophic $7,350/$0 – Select Network Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Silver HSA $2,700/20% - Premium Network Deductible $2,700 Coinsurance Not applicable Out of Pocket $4,300
Plan UPMC Advantage Silver $3,500/$30 - Partner Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Silver $1,750/$50 - Partner Network Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Inside Advantage for Individuals Bronze $6,950/$35 - Premium Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Silver $0/$50 - Premium Network Deductible $0 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Inside Advantage for Individuals Silver $3,500/$25 - Premium Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Tower UPMC Advantage Gold $800/$20 - Tower Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Inside Advantage for Individuals Gold $800/$20 - Premium Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Silver HSA $2,700/20% - Partner Network Deductible $2,700 Coinsurance Not applicable Out of Pocket $4,300
Plan UPMC Advantage Platinum $250/$20 - Select Network Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
Plan UPMC Advantage Catastrophic $7,350/$0 - Premium Network Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Platinum $250/$20 - Partner Network Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
Plan UPMC Advantage Silver $3,500/$25 - Select Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Bronze $6,950/$35 - Select Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Inside Advantage for Individuals Silver HSA $2,700/20% - Premium Network Deductible $2,700 Coinsurance Not applicable Out of Pocket $4,300
Plan UPMC Advantage Silver $3,500/$30 - Premium Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Gold $1,400$20 - Partner Network Deductible $1,400 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Silver $3,500/$25 - Premium Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Catastrophic $7,350/$0 - Partner Network Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Tower UPMC Advantage Silver $3,500/$25 - Tower Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Catastrophic $7,350/$0 - Premium Network Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Platinum $250/$20 - Premium Network Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
Plan UPMC Advantage Inside Advantage for Individuals Silver $1,750/$50 - Premium Network Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Silver $1,750/$50 - Select Network Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Bronze $6,950/$35 - Partner Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Gold $800/$20 - Partner Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
{"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) $800
Deductible (Family) $1,600
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $5,000
Out of Pocket Maximum (Family) $10,000

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
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 Data Not Available
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 Data Not Available
Rehabilitative Speech Therapy Data Not Available
Rehabilitative Occupational & Physical Therapy Data Not Available
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

Other Plans in Pennsylvania

Plan UPMC Advantage Silver $3,500/$25 - Partner Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Inside Advantage for Individuals Platinum $250/$20 - Premium Network Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
Plan UPMC Advantage Silver $1,750/$50 - Premium Network Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Inside Advantage for Individuals Silver $0/$50 - Premium Network Deductible $0 Coinsurance Not applicable Out of Pocket $7,350
Plan Tower UPMC Advantage Bronze $6,950/$35 - Tower Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Silver $0/$50 - Select Network Deductible $0 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Silver $0/$50 - Partner Network Deductible $0 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Gold $1,400/$20 - Premium Network Deductible $1,400 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Gold $1,400/$20 - Select Network Deductible $1,400 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Bronze $6,950/$35 - Premium Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Gold $800/$20 - Premium Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Silver HSA $2,700/20% - Select Network Deductible $2,700 Coinsurance Not applicable Out of Pocket $4,300
Plan UPMC Advantage Silver $3,500/$30 - Select Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Catastrophic $7,350/$0 – Select Network Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Silver HSA $2,700/20% - Premium Network Deductible $2,700 Coinsurance Not applicable Out of Pocket $4,300
Plan UPMC Advantage Silver $3,500/$30 - Partner Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Silver $1,750/$50 - Partner Network Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Inside Advantage for Individuals Bronze $6,950/$35 - Premium Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Silver $0/$50 - Premium Network Deductible $0 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Inside Advantage for Individuals Silver $3,500/$25 - Premium Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Tower UPMC Advantage Gold $800/$20 - Tower Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Inside Advantage for Individuals Gold $800/$20 - Premium Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Silver HSA $2,700/20% - Partner Network Deductible $2,700 Coinsurance Not applicable Out of Pocket $4,300
Plan UPMC Advantage Platinum $250/$20 - Select Network Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
Plan UPMC Advantage Catastrophic $7,350/$0 - Premium Network Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Platinum $250/$20 - Partner Network Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
Plan UPMC Advantage Silver $3,500/$25 - Select Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Bronze $6,950/$35 - Select Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Inside Advantage for Individuals Silver HSA $2,700/20% - Premium Network Deductible $2,700 Coinsurance Not applicable Out of Pocket $4,300
Plan UPMC Advantage Silver $3,500/$30 - Premium Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Gold $1,400$20 - Partner Network Deductible $1,400 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Silver $3,500/$25 - Premium Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Catastrophic $7,350/$0 - Partner Network Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Tower UPMC Advantage Silver $3,500/$25 - Tower Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Catastrophic $7,350/$0 - Premium Network Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Platinum $250/$20 - Premium Network Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
Plan UPMC Advantage Inside Advantage for Individuals Silver $1,750/$50 - Premium Network Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Silver $1,750/$50 - Select Network Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Bronze $6,950/$35 - Partner Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,350
Plan UPMC Advantage Gold $800/$20 - Partner Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000