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Medica with CHI Health Catastrophic
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Medica with CHI Health Catastrophic

Overview
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Medica with CHI Health 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 Lancaster 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
20305NE0050013
Coverage area
Lancaster 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 0-14 186
Premium Child Age 18 222
Premium Adult Individual Age 21 243
Premium Adult Individual Age 27 255
Premium Adult Individual Age 30 276
Premium Adult Individual Age 40 311
Premium Adult Individual Age 50 435
Premium Adult Individual Age 60 661
Premium Couple 21 487
Premium Couple 30 552
Premium Couple 40 622
Premium Couple 50 870
Premium Couple 60 1,322
Couple+1 child, Age 21 673
Couple+1 child, Age 30 739
Couple+1 child, Age 40 808
Couple+1 child, Age 50 1,056
Couple+2 children, Age 21 859
Couple+2 children, Age 30 925
Couple+2 children, Age 40 995
Couple+2 children, Age 50 1,242
Couple+3 or more Children, Age 21 1,046
Couple+3 or more Children, Age 30 1,111
Couple+3 or more Children, Age 40 1,181
Couple+3 or more Children, Age 50 1,428
Individual+1 child, Age 21 429
Individual+1 child, Age 30 462
Individual+1 child, Age 40 497
Individual+1 child, Age 50 621
Individual+2 children, Age 21 616
Individual+2 children, Age 30 649
Individual+2 children, Age 40 683
Individual+2 children, Age 50 807
Individual+3 or more children, Age 21 802
Individual+3 or more children, Age 30 835
Individual+3 or more children, Age 40 870
Individual+3 or more children, Age 50 993
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