AdventHealth Bronze HMO 60 1752

Plan Type: HMO
Plan Tier: Expanded Bronze
Medical Deductible - Individual: $7500
Medical Deductible - Family: Included in Medical
Drug Deductible - Individual: $7500
Drug Deductible - Family: Included in Medical
Out of Pocket Max - Individual: $7900
Out of Pocket Max - Family: $7900
Primary Care Visit: $35
Specialist Visit: $75
Emergency Room: 40% Coinsurance after deductible
Hospital - Physician: 40% Coinsurance after deductible
Hospital - Facility: 40% Coinsurance after deductible
Link to Full SBC: http://myAHplan.com/2020_sbc_1752
Plan Brochure:

Other Coverage:

Child Dental: Yes
Adult Dental No

Prescription Drug Pricing:

Generic Drugs: $35
Non-Preferred Brand Drugs: 40% Coinsurance after deductible
Preferred Brand Drugs: 35% Coinsurance after deductible
Specialty Drugs: 45% Coinsurance after deductible
Link to Full Policy Formulary: http://myAHplan.com/MP_formulary_2020
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