Share
Medicine Status
Elevate by Medica Bronze HSA Plus
Healthcare.gov Individual Medical Plan Finder
Contents
Explore
Search
Medicine Status
More
About Medicine Status
Copyright © 2020 MedicineStatus.com and Spring Launch Media LLC. All Rights Reserved.

All content on this website ("the Site") is the property of Spring Launch Media LLC. The collection and assembly of content on this Site are the exclusive property of Spring Launch Media LLC and are protected by copyright and other intellectual property laws. MedicineStatus.com does not provide medical advice, diagnosis, or treatment, and urges you to consult with a qualified medical provider for diagnosis, treatment, and for answers to your medical questions. MedicineStatus.com does not warrant or assume any legal liability or responsibility for the accuracy, completeness, or usefulness of any information disclosed. MedicineStatus.com does not assume any responsibility for any aspect of medical care administered based on the contents provided on this Site. The contents of MedicineStatus.com, such as text, images, graphics, or other material are solely for informational purposes. MedicineStatus.com does not recommend or endorse any specific provider, opinions, procedures, or other information on the Site. Rely on any information provided by MedicineStatus.com or displayed on this Site solely at your own risk. Consult a healthcare professional before taking any drug, choosing or changing any course of treatment.

Elevate by Medica Bronze HSA Plus

Overview
Back to Top

Elevate by Medica Bronze HSA Plus is an individual health health plan issued by Medica Insurance Company 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 Sarpy county, Nebraska.

What Type of Health Plan Is This?

This plan is an EPO plan, which is also known as an "Exclusive Provider Organization." An EPO is a managed care plan where services are covered so long as the the hospitals, dentists, and other health providers in the plan's network are used.

Where Can I Buy This Plan?

You can purchase this plan at HealthCare.gov.

About
Back to Top
Issuer
Medica Insurance Company
Plan ID
20305NE0030023
Coverage area
Sarpy County, Nebraska
Phone
Local Phone: 1-888-592-8211
Toll-Free: 1-888-592-8211
TTY: 1-800-833-7352
Plan type
EPO
Coverage type
Medical deductible
$3,100
Out-of-pocket maximum
$6,750
Generic drug co-pay
40% Coinsurance after deductible
Preferred brand drug co-pay
40% Coinsurance after deductible
Primary care physician visit cost
40% Coinsurance after deductible
Specialist doctor visit cost
40% Coinsurance after deductible
Doctor Visits
Primary Care Visit 40% Coinsurance after deductible
Specialist Visit 40% Coinsurance after deductible
Emergency Room Visit 40% Coinsurance after deductible
Inpatient Facility Visit 40% Coinsurance after deductible
Inpatient Physician Visit 40% Coinsurance after deductible
Prescription Drugs
Generic Drugs 40% Coinsurance after deductible
Preferred Brand Drugs 40% Coinsurance after deductible
Non-preferred Brand Drugs 40% Coinsurance after deductible
Specialty Drugs 30% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $3,100
Medical Maximum Out Of Pocket (Individual) $6,750
Medical Deductible (Family) $6,200
Medical Maximum Out Of Pocket (Family) $13,500
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 0-14 319
Premium Child Age 18 380
Premium Adult Individual Age 21 417
Premium Adult Individual Age 27 437
Premium Adult Individual Age 30 473
Premium Adult Individual Age 40 533
Premium Adult Individual Age 50 745
Premium Adult Individual Age 60 1,132
Premium Couple 21 834
Premium Couple 30 946
Premium Couple 40 1,066
Premium Couple 50 1,490
Premium Couple 60 2,264
Couple+1 child, Age 21 1,153
Couple+1 child, Age 30 1,266
Couple+1 child, Age 40 1,385
Couple+1 child, Age 50 1,809
Couple+2 children, Age 21 1,472
Couple+2 children, Age 30 1,585
Couple+2 children, Age 40 1,704
Couple+2 children, Age 50 2,128
Couple+3 or more Children, Age 21 1,791
Couple+3 or more Children, Age 30 1,904
Couple+3 or more Children, Age 40 2,023
Couple+3 or more Children, Age 50 2,447
Individual+1 child, Age 21 736
Individual+1 child, Age 30 792
Individual+1 child, Age 40 852
Individual+1 child, Age 50 1,064
Individual+2 children, Age 21 1,055
Individual+2 children, Age 30 1,111
Individual+2 children, Age 40 1,171
Individual+2 children, Age 50 1,383
Individual+3 or more children, Age 21 1,374
Individual+3 or more children, Age 30 1,430
Individual+3 or more children, Age 40 1,490
Individual+3 or more children, Age 50 1,702
Reference
Back to Top

  • 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