Choice SOLO POS HSA Coins. $6,000 ded. – POS
Network type: POS
Coverage tier: Expanded Bronze
Primary care visit: 25% after deductible
Specialist visit: 25% after deductible
Urgent care visit: 25% after deductible
Description
Health Care Plan Details
| Network type | POS |
| Deductible | N/A N/A |
| Out-of-pocket max | N/A per person N/A per family |
| Metal tier | Expanded Bronze |
Visit Copay
| Primary care visit | 25% after deductible |
| Specialist visit | 25% after deductible |
| Preventive care visit | No charge |
Urgent, Emergency Care, and Hospital Care
| Urgent care | 25% after deductible |
| Emergency room | 25% after deductible |
| Ambulance | 25% after deductible |
| Hospital stay (facility) | 25% after deductible |
| Hospital stay (physician) | 25% after deductible |
| Outpatient procedure (facility) | 25% after deductible |
| Outpatient procedure (physician) | 25% after deductible |
| Physical rehabilitation | 25% after deductible |
Maternitowny and Pregnancy
Pharmacy, Drugs, and Medication
| Generic | $10 per script after deductible copay |
| Brand | $60 per script after deductible copay |
| Non-preferred Brand | 50% after deductible, up to $500 per script copay, 50% after deductible, up to $500 per script |
| Specialty | 50% after deductible, up to $500 per script copay, 50% after deductible, up to $500 per script |
Lab Tests and Diagnostic Procedures
| X-rays | 25% after deductible |
| Imaging (CT/PET/MRI) | 25% after deductible |
| Blood work | 25% after deductible |
Mental and Psychiatric Health Care
| Mental Health outpatient services | 25% after deductible |
| Psychiatric hospital stay | 25% after deductible |
