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Prestige Bronze
The Prestige Bronze plan is good for an individual who wants a low monthly premium and quality coverage, without dental, vision or fitness benefits. You will pay $0 for most medical services once your deductible is met. There are separate copayments and coinsurance for prescription drugs. The below chart details the benefits of this plan.
Prestige Bronze Plan Highlights |
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DEDUCTIBLE |
Individual |
$9,100 |
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Family |
$18,200 |
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COINSURANCE |
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0% after deductible |
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OUT-OF- |
Individual |
$9,100 |
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Family |
$18,200 |
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BENEFITS |
Preventive Care |
$0 |
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Routine Vision Exam |
Not covered |
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Annual Dental Exam |
Not covered |
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Personal Doctor Visit |
0% after deductible |
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Virtual Visit |
$0 per visit |
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Specialist Visit |
0% after deductible |
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Chiropractic |
0% after deductible |
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Hospital Stay |
0% after deductible |
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Emergency Room |
0% after deductible |
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X-ray and Diagnostic Imaging |
0% after deductible |
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Prescription Drug Coverage
All Network Health’s Prestige plans have built-in pharmacy benefits. See the chart below for prescription drug coverage information.
Prestige Bronze Pharmacy Benefit Highlights |
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Retail |
Preventive Drugs |
$0 |
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Adherence Generics |
0% after deductible |
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Tier 1 Generics |
0% after deductible |
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Tier 2 Preferred Brand Drugs |
0% after deductible |
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Tier 3 Non-Preferred Brand Drugs |
0% after deductible |
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Tier 4 Preferred Specialty Drugs |
0% after deductible |
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Tier 5 Non-Preferred Specialty Drugs |
0% after deductible |
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