UPMC - UPMC Advantage Bronze $6,950/$35 - Premium Network

Pennsylvania, 2019

  • Plan Type

    PPO

  • Metal Tier

    Bronze

  • Out of Pocket Maximum

    $7,900

  • Deductible

    $6,950

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) $6,950
Deductible (Family) $13,900
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 No charge after deductible
Inpatient Facility No charge after deductible
Inpatient Physician No charge after deductible
Emergency Room Services No charge after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) No charge after deductible
Laboratory Outpatient and Professional Services No charge after deductible
X-Ray and Diagnostic Imaging No charge 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 No charge after deductible
Mental / Behavioral Health Outpatient No charge after deductible
Rehabilitative Speech Therapy No charge after deductible
Rehabilitative Occupational & Physical Therapy No charge after deductible
Outpatient Facility No charge after deductible
Outpatient Surgery No charge after deductible

Prescription Drugs

Generic Rx Data Not Available
Preferred Brand Rx 30% Coinsurance after deductible
Non Preferred Brand Rx 50% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible

Other Plans in Pennsylvania

Plan UPMC Advantage Catastrophic $7,900/$0 - Partner Network Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Tower UPMC Advantage Silver $3,500/$25 - Tower Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Platinum $250/$20 - Premium Network Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
Plan UPMC Advantage Catastrophic $7,900/$0 - Premium Network Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Bronze $6,950/$35 - Partner Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Silver $1,750/$50 - Select Network Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Gold $800/$20 - Premium Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Gold $800/$20 - Partner Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
Plan Tower UPMC Advantage Silver $3,500/$25 - Premium Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Platinum $250/$20 - Partner Network Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
Plan UPMC Advantage Bronze $6,950/$35 - Select Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Silver $3,500/$25 - Select Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Tower UPMC Advantage Bronze $6,950/$35 - Premium Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Silver $3,500/$25 - Premium Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Catastrophic $7,900/$0 - Select Network Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Silver $1,750/$50 - Partner Network Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Gold $800/$20 - Select Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Silver $0/$50 - Premium Network Deductible $0 Coinsurance Not applicable Out of Pocket $7,900
Plan Tower UPMC Advantage Gold $800/$20 - Tower Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Platinum $250/$20 - Select Network Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
Plan UPMC Advantage Silver $3,500/$25 - Partner Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Tower UPMC Advantage Gold $800/$20 - Premium Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Silver $1,750/$50 - Premium Network Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Silver $0/$50 - Select Network Deductible $0 Coinsurance Not applicable Out of Pocket $7,900
Plan Tower UPMC Advantage Bronze $6,950/$35 - Tower Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Silver $0/$50 - Partner Network Deductible $0 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Silver $3,500/$25 - Premium Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Gold $800/$20 - Premium Network Deductible $800 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 $7,900

Health Insurance Tools

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Health Exchange Guides

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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) $6,950
Deductible (Family) $13,900
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 No charge after deductible
Inpatient Facility No charge after deductible
Inpatient Physician No charge after deductible
Emergency Room Services No charge after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) No charge after deductible
Laboratory Outpatient and Professional Services No charge after deductible
X-Ray and Diagnostic Imaging No charge 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 No charge after deductible
Mental / Behavioral Health Outpatient No charge after deductible
Rehabilitative Speech Therapy No charge after deductible
Rehabilitative Occupational & Physical Therapy No charge after deductible
Outpatient Facility No charge after deductible
Outpatient Surgery No charge after deductible

Prescription Drugs

Generic Rx Data Not Available
Preferred Brand Rx 30% Coinsurance after deductible
Non Preferred Brand Rx 50% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible

Other Plans in Pennsylvania

Plan UPMC Advantage Catastrophic $7,900/$0 - Partner Network Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Tower UPMC Advantage Silver $3,500/$25 - Tower Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Platinum $250/$20 - Premium Network Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
Plan UPMC Advantage Catastrophic $7,900/$0 - Premium Network Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Bronze $6,950/$35 - Partner Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Silver $1,750/$50 - Select Network Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Gold $800/$20 - Premium Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Gold $800/$20 - Partner Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
Plan Tower UPMC Advantage Silver $3,500/$25 - Premium Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Platinum $250/$20 - Partner Network Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
Plan UPMC Advantage Bronze $6,950/$35 - Select Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Silver $3,500/$25 - Select Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Tower UPMC Advantage Bronze $6,950/$35 - Premium Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Silver $3,500/$25 - Premium Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Catastrophic $7,900/$0 - Select Network Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Silver $1,750/$50 - Partner Network Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Gold $800/$20 - Select Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Silver $0/$50 - Premium Network Deductible $0 Coinsurance Not applicable Out of Pocket $7,900
Plan Tower UPMC Advantage Gold $800/$20 - Tower Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Platinum $250/$20 - Select Network Deductible $250 Coinsurance Not applicable Out of Pocket $1,500
Plan UPMC Advantage Silver $3,500/$25 - Partner Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Tower UPMC Advantage Gold $800/$20 - Premium Network Deductible $800 Coinsurance Not applicable Out of Pocket $5,000
Plan UPMC Advantage Silver $1,750/$50 - Premium Network Deductible $1,750 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Silver $0/$50 - Select Network Deductible $0 Coinsurance Not applicable Out of Pocket $7,900
Plan Tower UPMC Advantage Bronze $6,950/$35 - Tower Network Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Silver $0/$50 - Partner Network Deductible $0 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Silver $3,500/$25 - Premium Network Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,900
Plan UPMC Advantage Gold $800/$20 - Premium Network Deductible $800 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 $7,900