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Medica Insure Catastrophic
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Medica Insure Catastrophic

Overview
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Medica Insure Catastrophic 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
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Issuer
Medica Insurance Company
Plan ID
20305NE0040013
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
$7,900
Out-of-pocket maximum
$7,900
Generic drug co-pay
No Charge after Deductible
Preferred brand drug co-pay
No Charge after Deductible
Primary care physician visit cost
$30 Copay with deductible
Specialist doctor visit cost
No Charge after Deductible
Doctor Visits
Primary Care Visit $30 Copay with deductible
Specialist Visit No Charge after Deductible
Emergency Room Visit No Charge after Deductible
Inpatient Facility Visit No Charge after Deductible
Inpatient Physician Visit No Charge after Deductible
Prescription Drugs
Generic Drugs No Charge after Deductible
Preferred Brand Drugs No Charge after Deductible
Non-preferred Brand Drugs No Charge after Deductible
Specialty Drugs No Charge after Deductible
Medical Deductible
Medical Deductible (Individual) $7,900
Medical Maximum Out Of Pocket (Individual) $7,900
Medical Deductible (Family) $15,800
Medical Maximum Out Of Pocket (Family) $15,800
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 0-14 243
Premium Child Age 18 290
Premium Adult Individual Age 21 317
Premium Adult Individual Age 27 332
Premium Adult Individual Age 30 360
Premium Adult Individual Age 40 405
Premium Adult Individual Age 50 567
Premium Adult Individual Age 60 862
Premium Couple 21 635
Premium Couple 30 721
Premium Couple 40 811
Premium Couple 50 1,134
Premium Couple 60 1,724
Couple+1 child, Age 21 878
Couple+1 child, Age 30 964
Couple+1 child, Age 40 1,054
Couple+1 child, Age 50 1,377
Couple+2 children, Age 21 1,121
Couple+2 children, Age 30 1,207
Couple+2 children, Age 40 1,297
Couple+2 children, Age 50 1,620
Couple+3 or more Children, Age 21 1,364
Couple+3 or more Children, Age 30 1,450
Couple+3 or more Children, Age 40 1,540
Couple+3 or more Children, Age 50 1,863
Individual+1 child, Age 21 560
Individual+1 child, Age 30 603
Individual+1 child, Age 40 648
Individual+1 child, Age 50 810
Individual+2 children, Age 21 803
Individual+2 children, Age 30 846
Individual+2 children, Age 40 891
Individual+2 children, Age 50 1,053
Individual+3 or more children, Age 21 1,046
Individual+3 or more children, Age 30 1,089
Individual+3 or more children, Age 40 1,134
Individual+3 or more children, Age 50 1,296
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