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

Pennsylvania, 2018

  • Plan Type

    EPO

  • Metal Tier

    Platinum

  • Out of Pocket Maximum

    $1,500

  • Deductible

    $250

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) $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 $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 Gold $800/$20 - Select Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
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 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
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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) $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 $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 Gold $800/$20 - Select Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
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 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