Montana - Access Care Bronze

Montana, 2019

  • Plan Type

    PPO

  • Metal Tier

    Bronze

  • Out of Pocket Maximum

    $7,900

  • Deductible

    $7,200

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) $7,200
Deductible (Family) $14,400
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,900
Out of Pocket Maximum (Family) $15,800

Doctor Visits

Primary Care Visit $60 Copay after deductible
Specialist Visit 60% Coinsurance after deductible
Inpatient Facility 60% Coinsurance after deductible
Inpatient Physician 60% Coinsurance after deductible
Emergency Room Services 60% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 60% Coinsurance after deductible
Laboratory Outpatient and Professional Services 60% Coinsurance after deductible
X-Ray and Diagnostic Imaging 60% Coinsurance after deductible

Health Management Programs

Asthma Available
Depression Not available
Diabetes Available
Heart Disease Not available
High Blood Pressure / High Cholesterol Not available
Lower Back Pain Not available
Pain Management Not available
Pregnancy Not available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient 60% Coinsurance after deductible
Mental / Behavioral Health Outpatient $60 Copay after deductible
Rehabilitative Speech Therapy 60% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 60% Coinsurance after deductible
Outpatient Facility 60% Coinsurance after deductible
Outpatient Surgery 60% Coinsurance after deductible

Prescription Drugs

Generic Rx $15 Copay after deductible
Preferred Brand Rx $125 Copay after deductible
Non Preferred Brand Rx $160 Copay after deductible
Specialty Drugs $185 Copay after deductible

Other Plans in Montana

Plan Access Care Expanded Bronze Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Connected Care Bronze Plus Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Connected Care Silver Deductible $3,300 Coinsurance Not applicable Out of Pocket $7,900
Plan Access Care Silver Deductible $3,300 Coinsurance Not applicable Out of Pocket $7,900
Plan Connected Care Bronze Deductible $7,200 Coinsurance Not applicable Out of Pocket $7,900
Plan Connected Care Silver Option 2 Deductible $5,700 Coinsurance Not applicable Out of Pocket $7,900
Plan Access Care Bronze Plus Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Connected Care Expanded Bronze Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Connected Care Gold Deductible $750 Coinsurance Not applicable Out of Pocket $5,750
Plan Access Care Gold Deductible $800 Coinsurance Not applicable Out of Pocket $5,750
Plan Connected Care Catastrophic Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
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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) $7,200
Deductible (Family) $14,400
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,900
Out of Pocket Maximum (Family) $15,800

Doctor Visits

Primary Care Visit $60 Copay after deductible
Specialist Visit 60% Coinsurance after deductible
Inpatient Facility 60% Coinsurance after deductible
Inpatient Physician 60% Coinsurance after deductible
Emergency Room Services 60% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 60% Coinsurance after deductible
Laboratory Outpatient and Professional Services 60% Coinsurance after deductible
X-Ray and Diagnostic Imaging 60% Coinsurance after deductible

Health Management Programs

Asthma Available
Depression Not available
Diabetes Available
Heart Disease Not available
High Blood Pressure / High Cholesterol Not available
Lower Back Pain Not available
Pain Management Not available
Pregnancy Not available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient 60% Coinsurance after deductible
Mental / Behavioral Health Outpatient $60 Copay after deductible
Rehabilitative Speech Therapy 60% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 60% Coinsurance after deductible
Outpatient Facility 60% Coinsurance after deductible
Outpatient Surgery 60% Coinsurance after deductible

Prescription Drugs

Generic Rx $15 Copay after deductible
Preferred Brand Rx $125 Copay after deductible
Non Preferred Brand Rx $160 Copay after deductible
Specialty Drugs $185 Copay after deductible

Other Plans in Montana

Plan Access Care Expanded Bronze Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Connected Care Bronze Plus Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Connected Care Silver Deductible $3,300 Coinsurance Not applicable Out of Pocket $7,900
Plan Access Care Silver Deductible $3,300 Coinsurance Not applicable Out of Pocket $7,900
Plan Connected Care Bronze Deductible $7,200 Coinsurance Not applicable Out of Pocket $7,900
Plan Connected Care Silver Option 2 Deductible $5,700 Coinsurance Not applicable Out of Pocket $7,900
Plan Access Care Bronze Plus Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Connected Care Expanded Bronze Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Connected Care Gold Deductible $750 Coinsurance Not applicable Out of Pocket $5,750
Plan Access Care Gold Deductible $800 Coinsurance Not applicable Out of Pocket $5,750
Plan Connected Care Catastrophic Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900