AvMed Entrust Bronze 650 (2024) – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $75 copay
Specialist visit: No charge after deductible
Urgent care visit: No charge after deductible
Description
Health Care Plan Details
| Network type | HMO |
| Deductible | $8,750 per person $8,750 per person |
| Out-of-pocket max | $8,750 per person $17,500 per family |
| Metal tier | Expanded Bronze |
Visit Copay
| Primary care visit | $75 copay |
| Specialist visit | No charge after deductible |
| Preventive care visit | No charge |
Urgent, Emergency Care, and Hospital Care
| Urgent care | No charge after deductible |
| Emergency room | No charge after deductible |
| Ambulance | No charge after deductible |
| Hospital stay (facility) | No charge after deductible |
| Hospital stay (physician) | No charge after deductible |
| Outpatient procedure (facility) | No charge after deductible |
| Outpatient procedure (physician) | No charge after deductible |
| Physical rehabilitation | No charge after deductible |
Maternitowny and Pregnancy
| Well baby care | No charge |
| Labor, delivery, hospital stay | No charge after deductible |
Pharmacy, Drugs, and Medication
| Generic | $25 copay |
| Brand | No charge after deductible |
| Non-preferred Brand | No charge after deductible |
| Specialty | No charge after deductible |
Lab Tests and Diagnostic Procedures
| X-rays | No charge after deductible |
| Imaging (CT/PET/MRI) | No charge after deductible |
| Blood work | No charge after deductible |
Mental and Psychiatric Health Care
| Mental Health outpatient services | $75 copay |
| Psychiatric hospital stay | No charge after deductible |
Health Plan Provider Information
| Health Plan Benefits | https://www.avmed.org/images/pdf/providers/patients/eligibility/AVINHB16180101240623.pdf |
| Drug and medication plan formulary | https://www.avmed.org/media/li3fglxe/2024-individual-and-family-plan-formulary-non-standard.pdf |
| Search doctor list | https://avmed.sapphirecareselect.com/?network_id=112&ci=AVMED&geo_location= |
