Regence Cascade Bronze Individual and Family Network – EPO
Network type: EPO
Coverage tier: Expanded Bronze
Primary care visit: first 2 visit(s) $0 then $50 copay
Specialist visit: first 2 visit(s) $0 then $100 copay after deductible
Urgent care visit: first 2 visit(s) $0 then $100 copay
Description
Health Care Plan Details
Network type | EPO |
Deductible | $6,000 per person $6,000 per person |
Out-of-pocket max | $9,200 per person $18,400 per family |
Metal tier | Expanded Bronze |
Visit Copay
Primary care visit | first 2 visit(s) $0 then $50 copay |
Specialist visit | first 2 visit(s) $0 then $100 copay after deductible |
Preventive care visit | No charge |
Urgent, Emergency Care, and Hospital Care
Urgent care | first 2 visit(s) $0 then $100 copay |
Emergency room | 40% after deductible |
Ambulance | 40% after deductible |
Hospital stay (facility) | 40% after deductible |
Hospital stay (physician) | 40% after deductible |
Outpatient procedure (facility) | 40% after deductible |
Outpatient procedure (physician) | 40% after deductible |
Physical rehabilitation | 40% after deductible |
Maternitowny and Pregnancy
Labor, delivery, hospital stay | 40% after deductible |
Pharmacy, Drugs, and Medication
Generic | $32 copay |
Brand | 40% after deductible |
Non-preferred Brand | 40% after deductible |
Specialty | 40% after deductible |
Lab Tests and Diagnostic Procedures
X-rays | 40% after deductible |
Imaging (CT/PET/MRI) | 40% after deductible |
Blood work | 40% after deductible |
Mental and Psychiatric Health Care
Mental Health outpatient services | first 2 visit(s) $0 then $50 copay |
Psychiatric hospital stay | 40% after deductible |