This plan is designed for an individual who wants to offset their medical expenses with a health savings plan (HSA). An HSA can be combined with this plan, as displayed here. The Prestige Bronze 50 HDHP has the lowest deductible of all the Network Health Bronze level plans. Once you’ve met your deductible, you are responsbile for 50 percent coinsurance on covered in-network visits. In addition, you get a $0 annual vision exam and dental exam for each covered member. The below chart details the benefits of this plan.
Prestige Bronze 50 HDHP Plan Highlights |
|||
|
DEDUCTIBLE |
Individual |
$3,500 |
|
|
Family |
$7,000 |
||
|
COINSURANCE |
|
50% |
|
|
OUT-OF- |
Individual |
$6,900 |
|
|
Family |
$13,800 |
||
|
BENEFITS |
Preventive Care |
$0 |
|
|
Routine Vision Exam |
$0 |
||
|
Annual Dental Exam |
$0 |
||
|
Personal Doctor Visit |
50% after deductible |
||
|
Virtual Visit |
0% after deductible |
||
|
Specialist Visit |
50% after deductible |
||
|
Chiropractic |
50% after deductible |
||
|
Hospital Stay |
50% after deductible |
||
|
Emergency Room |
50% after deductible |
||
|
X-ray and Diagnostic Imaging |
50% after deductible |
||
All Network Health’s Prestige plans have built-in pharmacy benefits. See the chart below for prescription drug coverage information.
Prestige Bronze 50 HDHP Pharmacy Benefit Highlights |
||
|
Retail |
Preventive Drugs |
$0 |
|
Tier 1 Adherence Generics (limited only to categories of select antidiabetics, statins and RAS antagonists) |
0% after deductible |
|
|
Tier 2 Generics |
30% after deductible |
|
|
Tier 3 Brand Drugs |
40% after deductible |
|
|
Tier 4 Non-Preferred Brand Drugs |
50% after deductible |
|
|
Tier 5 Preferred Specialty Drugs |
35% after deductible |
|
|
Tier 6 Non-Preferred Specialty Drugs |
50% after deductible |
|