More Information
Health Insurance Tools
Health Exchange Guides
- What is a Health Insurance Exchange?
- Understanding the ACA Subsidies
- Cost Sharing Reductions
- Minimum Essential Coverage
- What Is An Insurance Rating Area?
- The Individual Mandate and Penalties
- Inpatient vs Outpatient Care and Coverage
- Copay vs Coinsurance
- Average Cost of Health Insurance
- How Age Affects Your Health Insurance Costs
Visualizations and Data
Other Insurance Research
Gundersen - Performance Bronze 7500 - Copay $80/$160
Illinois, 2019
Plan Type
HMO
Metal Tier
Expanded Bronze
Out of Pocket Maximum
$7,900
Deductible
$7,500
Emergency Room Care: Data Not Available
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) | $7,500 |
|---|---|
| Deductible (Family) | $15,000 |
| Coinsurance | Not applicable |
| Out of Pocket Maximum (Individual) | $7,900 |
| Out of Pocket Maximum (Family) | $15,800 |
Doctor Visits
| Primary Care Visit | Data Not Available |
|---|---|
| Specialist Visit | Data Not Available |
| Inpatient Facility | 50% Coinsurance after deductible |
| Inpatient Physician | 50% Coinsurance after deductible |
| Emergency Room Services | Data Not Available |
Tests and Imaging
| Imaging (CT/PET Scans, MRIs) | 50% Coinsurance after deductible |
|---|---|
| Laboratory Outpatient and Professional Services | 50% Coinsurance after deductible |
| X-Ray and Diagnostic Imaging | 50% 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 | Not available |
| Pregnancy | Available |
| Weight Loss | Not available |
Other
| Mental / Behavioral Health Inpatient | 50% Coinsurance after deductible |
|---|---|
| Mental / Behavioral Health Outpatient | Data Not Available |
| Rehabilitative Speech Therapy | 50% Coinsurance after deductible |
| Rehabilitative Occupational & Physical Therapy | 50% Coinsurance after deductible |
| Outpatient Facility | 50% Coinsurance after deductible |
| Outpatient Surgery | 50% 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 Illinois
| Plan | Deductible | Coinsurance | Out of Pocket |
|---|---|---|---|
| Plan Performance Gold Maintenance - Copay $40/$90 | Deductible $1,500 | Coinsurance Not applicable | Out of Pocket $7,900 |
| Plan Performance Gold HSA 2000 | Deductible $2,000 | Coinsurance Not applicable | Out of Pocket $6,650 |
| Plan Performance Catastrophic | Deductible $7,900 | Coinsurance Not applicable | Out of Pocket $7,900 |
| Plan Performance Silver HSA 5400 | Deductible $5,400 | Coinsurance Not applicable | Out of Pocket $5,400 |
| Plan Performance Bronze HSA 6750 | Deductible $6,750 | Coinsurance Not applicable | Out of Pocket $6,750 |
| Plan Performance Silver 4000 - Copay $45/$90 | Deductible $4,000 | Coinsurance Not applicable | Out of Pocket $7,900 |
| Plan Performance Gold HSA 3000 | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $3,000 |
| Plan Performance Gold 2000 - Copay $30/$70 | Deductible $2,000 | Coinsurance Not applicable | Out of Pocket $7,900 |
| Plan Performance Silver 7900 - Copay $80/$160 | Deductible $7,900 | Coinsurance Not applicable | Out of Pocket $7,900 |
| Plan Performance Bronze 7900 - Copay $50/$100 | Deductible $7,900 | Coinsurance Not applicable | Out of Pocket $7,900 |
| Plan Performance Silver 5000 - Copay $50/$100 | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $7,900 |