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=