SelectHealth

Select Health Value Bronze $6900 Medical Deductible

Plan Overview

Medical Deductible
  • Individual: $6,900
  • Family: $13,800
  • Per Person: $6,900
Prescription Drug Deductible
  • Individual: Included in Medical
  • Family: Included in Medical
  • Per Person: Included in Medical
Medical Out-of-Pocket Maximum
  • Individual: $9,200
  • Family: $18,400
  • Per Person: $9,200
Drug Out-of-Pocket Maximum
  • Individual: Included in Medical
  • Family: Included in Medical
  • Per Person: Included in Medical

Office Visit

Primary Doctor
  • Standard: Copay: $35.00 | Coinsurance: Not Applicable
Specialist
  • Standard: Copay: $70.00 Copay after deductible | Coinsurance: Not Applicable

Prescription Drug Information

Preferred Brand Drugs
  • Standard: Copay: $55.00 Copay after deductible | Coinsurance: Not Applicable
Non Preferred Brand Drugs
  • Standard: Copay: Not Applicable | Coinsurance: 50.00% Coinsurance after deductible
Generic Drugs
  • Standard: Copay: $15.00 | Coinsurance: Not Applicable
Specialty Drugs
  • Standard: Copay: Not Applicable | Coinsurance: 50.00% Coinsurance after deductible

Inpatient Coverage

Hospital Services
  • Standard: Copay: Not Applicable | Coinsurance: 40.00% Coinsurance after deductible
Inpatient Services
  • Standard: Copay: Not Applicable | Coinsurance: 40.00% Coinsurance after deductible

Emergency and Urgent Care

Emergency Room
  • Standard: Copay: Not Applicable | Coinsurance: 40.00% Coinsurance after deductible