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Bronze Classic Saver 5000
Healthcare.gov Individual Medical Plan Finder
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Bronze Classic Saver 5000

Overview
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Bronze Classic Saver 5000 is an individual health health plan issued by QCA Health Plan, Inc. and is available for the year 2019. This health plan is offered by the federal government through HealthCare.gov and the Affordable Care Act (ACA).

Where Do I Need to Live to Quality for this Plan?

This plan is available for qualifying individuals who live in White county, Arkansas.

What Type of Health Plan Is This?

This plan is a POS plan, or a Point of Service plan. This plan requires you get a referral from your primary care doctor in order to see a specialist doctor. You pay less if you use providers that are in-network and you pay more if you use those that are out-of-network.

Where Can I Buy This Plan?

You can purchase this plan at HealthCare.gov.

About
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Issuer
QCA Health Plan, Inc.
Plan ID
70525AR0070001
Coverage area
White County, Arkansas
Phone
Local Phone: 1-501-228-7111x7006
Toll-Free: 1-800-235-7111
TTY: 1-501-219-5188
Plan type
POS
Coverage type
Medical deductible
$5,000
Out-of-pocket maximum
$6,450
Generic drug co-pay
50% Coinsurance after deductible
Preferred brand drug co-pay
50% Coinsurance after deductible
Primary care physician visit cost
50% Coinsurance after deductible
Specialist doctor visit cost
50% Coinsurance after deductible
Doctor Visits
Primary Care Visit 50% Coinsurance after deductible
Specialist Visit 50% Coinsurance after deductible
Emergency Room Visit 50% Coinsurance after deductible
Inpatient Facility Visit 50% Coinsurance after deductible
Inpatient Physician Visit 50% Coinsurance after deductible
Prescription Drugs
Generic Drugs 50% Coinsurance after deductible
Preferred Brand Drugs 50% Coinsurance after deductible
Non-preferred Brand Drugs 50% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $5,000
Medical Maximum Out Of Pocket (Individual) $6,450
Medical Deductible (Family) $10,000
Medical Maximum Out Of Pocket (Family) $12,900
Drug Deductible
Drug Deductible (Individual) Included in Medical
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) Included in Medical
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 100.00%
Premium Child Age 0-14 214
Premium Child Age 18 255
Premium Adult Individual Age 21 280
Premium Adult Individual Age 27 293
Premium Adult Individual Age 30 318
Premium Adult Individual Age 40 358
Premium Adult Individual Age 50 500
Premium Adult Individual Age 60 760
Premium Couple 21 560
Premium Couple 30 636
Premium Couple 40 716
Premium Couple 50 1,001
Premium Couple 60 1,521
Couple+1 child, Age 21 775
Couple+1 child, Age 30 850
Couple+1 child, Age 40 931
Couple+1 child, Age 50 1,215
Couple+2 children, Age 21 989
Couple+2 children, Age 30 1,065
Couple+2 children, Age 40 1,145
Couple+2 children, Age 50 1,430
Couple+3 or more Children, Age 21 1,204
Couple+3 or more Children, Age 30 1,279
Couple+3 or more Children, Age 40 1,359
Couple+3 or more Children, Age 50 1,644
Individual+1 child, Age 21 494
Individual+1 child, Age 30 532
Individual+1 child, Age 40 572
Individual+1 child, Age 50 715
Individual+2 children, Age 21 709
Individual+2 children, Age 30 747
Individual+2 children, Age 40 787
Individual+2 children, Age 50 929
Individual+3 or more children, Age 21 923
Individual+3 or more children, Age 30 961
Individual+3 or more children, Age 40 1,001
Individual+3 or more children, Age 50 1,144
Reference
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  • HealthCare.gov. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov
  • The 'metal' categories: Bronze, Silver, Gold & Platinum. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plans-categories
  • Health insurance plan & network types: HMOs, PPOs, and more. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plan-types