This plan, as displayed here, is perfect for a person who wants to pair an individual health plan with a health savings account (HSA). With Prestige Bronze 20 HDHP, once your deductible is met, you will be responsible for 20 percent coinsurance on additional in-network services you need. Preventive care is covered 100 percent. In addition, you get a $0 annual vision exam and two dental exams for each covered member. The below chart details the benefits of this plan.
This plan is also available without dental and vision benefits.
Prestige Bronze 20 HDHP Plan Highlights |
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DEDUCTIBLE |
Individual |
$6,500 |
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Family |
$13,000 |
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COINSURANCE |
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20% |
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OUT-OF- |
Individual |
$7,500 |
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Family |
$15,000 |
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BENEFITS |
Preventive Care |
$0 |
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Routine Vision Exam |
$0 |
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Annual Dental Exam |
Reimbursement |
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Personal Doctor Visit |
20% after deductible |
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Virtual Visit |
0% after deductible |
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Specialist Visit |
20% after deductible |
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Chiropractic |
20% after deductible |
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Hospital Stay |
20% after deductible |
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Emergency Room |
20% after deductible |
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X-ray and Diagnostic Imaging |
20% after deductible |
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All Network Health’s Prestige plans have built-in pharmacy benefits. See the chart below for prescription drug coverage information.
Prestige Bronze 20 HDHP Pharmacy Benefit Highlights |
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Retail |
Preventive Drugs |
$0 |
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Tier 1 Generic and Adherence Generic Drugs Adherence Generics are limited to specific medications to treat certain conditions and are designated in the comprehensive drug list with the label “$0” and are available at no cost, subject to applicable deductible |
20% after deductible |
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Tier 2 Preferred Brand Drugs |
20% after deductible |
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Tier 3 Non-Preferred Brand Drugs |
50% after deductible |
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Tier 4 Preferred Specialty Drugs |
40% after deductible |
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Tier 5 Non-Preferred Specialty Drugs |
50% after deductible |
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