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Medica Insure Bronze HSA Plus
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Medica Insure Bronze HSA Plus

Overview
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Medica Insure 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 Saunders 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
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Issuer
Medica Insurance Company
Plan ID
20305NE0040023
Coverage area
Saunders 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 0-14 375
Premium Child Age 18 448
Premium Adult Individual Age 21 490
Premium Adult Individual Age 27 514
Premium Adult Individual Age 30 557
Premium Adult Individual Age 40 627
Premium Adult Individual Age 50 876
Premium Adult Individual Age 60 1,332
Premium Couple 21 981
Premium Couple 30 1,114
Premium Couple 40 1,254
Premium Couple 50 1,753
Premium Couple 60 2,664
Couple+1 child, Age 21 1,357
Couple+1 child, Age 30 1,489
Couple+1 child, Age 40 1,629
Couple+1 child, Age 50 2,128
Couple+2 children, Age 21 1,732
Couple+2 children, Age 30 1,865
Couple+2 children, Age 40 2,005
Couple+2 children, Age 50 2,504
Couple+3 or more Children, Age 21 2108
Couple+3 or more Children, Age 30 2,240
Couple+3 or more Children, Age 40 2,380
Couple+3 or more Children, Age 50 2,879
Individual+1 child, Age 21 866
Individual+1 child, Age 30 932
Individual+1 child, Age 40 1,002
Individual+1 child, Age 50 1,252
Individual+2 children, Age 21 1,241
Individual+2 children, Age 30 1,307
Individual+2 children, Age 40 1,378
Individual+2 children, Age 50 1,627
Individual+3 or more children, Age 21 1,617
Individual+3 or more children, Age 30 1,683
Individual+3 or more children, Age 40 1,753
Individual+3 or more children, Age 50 2,002
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