First - my Priority Blue Flex HMO Bronze 4000

Pennsylvania, 2019

  • Plan Type

    HMO

  • Metal Tier

    Expanded Bronze

  • Out of Pocket Maximum

    $7,900

  • Deductible

    $4,000

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) $4,000
Deductible (Family) $8,000
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 30% Coinsurance after deductible
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible
Emergency Room Services 30% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 30% Coinsurance after deductible
Laboratory Outpatient and Professional Services 30% Coinsurance after deductible
X-Ray and Diagnostic Imaging 30% 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 Available

Other

Mental / Behavioral Health Inpatient 30% Coinsurance after deductible
Mental / Behavioral Health Outpatient 30% Coinsurance after deductible
Rehabilitative Speech Therapy 30% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 30% Coinsurance after deductible
Outpatient Facility 30% Coinsurance after deductible
Outpatient Surgery 30% Coinsurance after deductible

Prescription Drugs

Generic Rx 30% Coinsurance after deductible
Preferred Brand Rx 30% Coinsurance after deductible
Non Preferred Brand Rx 30% Coinsurance after deductible
Specialty Drugs 30% Coinsurance after deductible

Other Plans in Pennsylvania

Plan my Priority Blue Major Events HMO 7900 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan my Priority Blue Flex HMO Gold 1000 - 2 Free PCP Visits Deductible $1,000 Coinsurance Not applicable Out of Pocket $7,000
Plan my Priority Blue Flex HMO Silver 2100 - 2 Free PCP Visits Deductible $2,100 Coinsurance Not applicable Out of Pocket $7,800
Plan my Lehigh Valley Flex Blue HMO Gold 800 - 2 Free PCP Visit Deductible $800 Coinsurance Not applicable Out of Pocket $7,000
Plan my Priority Blue Flex HMO Silver 0 Deductible $0 Coinsurance Not applicable Out of Pocket $7,800
Plan my Priority Blue Flex HMO Silver 4550 HSA Deductible $4,450 Coinsurance Not applicable Out of Pocket $6,650
Plan my Priority Blue Flex HMO Bronze 7900 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan my Lehigh Valley Flex Blue HMO Silver 1900 - 2 Free PCP Visits Deductible $1,900 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) $4,000
Deductible (Family) $8,000
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 30% Coinsurance after deductible
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible
Emergency Room Services 30% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 30% Coinsurance after deductible
Laboratory Outpatient and Professional Services 30% Coinsurance after deductible
X-Ray and Diagnostic Imaging 30% 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 Available

Other

Mental / Behavioral Health Inpatient 30% Coinsurance after deductible
Mental / Behavioral Health Outpatient 30% Coinsurance after deductible
Rehabilitative Speech Therapy 30% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 30% Coinsurance after deductible
Outpatient Facility 30% Coinsurance after deductible
Outpatient Surgery 30% Coinsurance after deductible

Prescription Drugs

Generic Rx 30% Coinsurance after deductible
Preferred Brand Rx 30% Coinsurance after deductible
Non Preferred Brand Rx 30% Coinsurance after deductible
Specialty Drugs 30% Coinsurance after deductible

Other Plans in Pennsylvania

Plan my Priority Blue Major Events HMO 7900 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan my Priority Blue Flex HMO Gold 1000 - 2 Free PCP Visits Deductible $1,000 Coinsurance Not applicable Out of Pocket $7,000
Plan my Priority Blue Flex HMO Silver 2100 - 2 Free PCP Visits Deductible $2,100 Coinsurance Not applicable Out of Pocket $7,800
Plan my Lehigh Valley Flex Blue HMO Gold 800 - 2 Free PCP Visit Deductible $800 Coinsurance Not applicable Out of Pocket $7,000
Plan my Priority Blue Flex HMO Silver 0 Deductible $0 Coinsurance Not applicable Out of Pocket $7,800
Plan my Priority Blue Flex HMO Silver 4550 HSA Deductible $4,450 Coinsurance Not applicable Out of Pocket $6,650
Plan my Priority Blue Flex HMO Bronze 7900 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan my Lehigh Valley Flex Blue HMO Silver 1900 - 2 Free PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900