Caresource 311703368 – Bronze First 7500 25 Generic Drugs

Insurance Plan

Bronze First 7500 $25 Generic Drugs

Type:HMO
Insurer:CareSource
Coverage:Individual

Summary

Plan Info & Network Details

Plan ID:13591NC0010002

State:NC

Metal Level:Expanded Bronze

HSA Eligible:No

Out-of-Network Coverage:Yes

Out-of-Country Coverage Description:Emergency Services Only

Out-of-Service Area Description:Emergency Services Only
National Network:No

Cost Sharing Details

Out of Pocket Maximum

Individual

$9200 per person

Family (Group)

$18400 per group

Deductible

Individual

$7500 per person

Family (Group)

$15000 per group

Coinsurance

Rate

50.00%

Out of Network Costs

Maximum

Individual

per person not applicable

Family (Group)

per group not applicable

Deductible

Individual

per person not applicable

Family (Group)

per group not applicable

Plan Features & Resources

The Plan Features & Resources section highlights important aspects of a health plan, such as specific options available to members, like the Child-Only Option, which enables enrollment for both adults and children separately. It also provides Additional Resources like downloadable brochures and links to the Premium Payment Website for managing payments. This section is designed to give users access to key features and helpful documents related to their plan.

Plan Features

Wellness Program: Yes
Disease Management Programs: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy
Notice Pregnancy : Yes
Referral Specialist : No
Child-Only Option: Allows Adult and Child-Only

Covered Services

Covered Services outlines the different types of services and areas covered by your insurance plan. This includes the Dental-Only Plan, which limits coverage to dental services only, excluding other health-related services. Out-of-Country Coverage refers to services provided outside the country, generally covered at an out-of-network level. Out-of-Service Area Coverage applies to services received outside of the designated service area, also typically covered at the out-of-network rate. Lastly, IN Coverage is specific to a certain state (for example, Indiana), indicating that coverage applies to services or providers within that state. These categories help define the scope of your plan's coverage and the areas where services are covered.

Cost Sharing for Common Conditions

Cost sharing for common conditions generally refers to the portion of health care costs that a person is responsible for under their health insurance plan. This includes different components like the deductible, copayment, coinsurance, and limits for specific medical conditions or treatments. The deductible is the amount a patient must pay out-of-pocket before their insurance begins covering the cost of care. Copayments are fixed amounts that the insured pays for medical services or prescriptions, while coinsurance is the percentage of costs that the insured must pay after the deductible has been met. Limits define the maximum amount a person will have to pay for a specific treatment or condition under their health insurance plan. Understanding these elements helps individuals plan for potential out-of-pocket expenses when managing common health conditions, ensuring they know what to expect financially.

Having a Baby

Deductible:$7,500
Copayment:$100
Coinsurance:$1,200
Limit:$0

Having Diabetes

Deductible:$4,300
Copayment:$500
Coinsurance:$0
Limit:$0

Having a Simple Fracture

Deductible:$2,300
Copayment:$200
Coinsurance:$0
Limit:$0

Plan Attributes

The Plan Attributes section provides an overview of the various features and details that define the structure of your insurance plan. This includes key attributes such as coverage limits, specific benefits, and services offered under the plan. It highlights important factors like the type of care covered, out-of-network options, and any additional resources available. Understanding these attributes will help you get a clear picture of your plan’s coverage and how it fits your healthcare needs.

No plan attributes available.

Service Area Coverage

The Service Area Coverage section outlines the geographical areas where your health plan provides coverage. It includes details on which counties or ZIP codes are covered, helping you to understand the locations where you can access healthcare services under your plan. This coverage may vary depending on whether the area is serviced by an in-network provider. Each county or ZIP code listed shows whether it is covered by the plan and any specific limitations or conditions tied to the location. Ensure your area is covered for full access to the plan's benefits.

No service area information available.

Hospitals That Accept This Insurance

The Hospitals That Accept This Insurance section provides a list of hospitals that are covered under the insurance plan you are currently reviewing. It includes important details such as the name of the hospital, the number of providers and beds available, the specialties offered, and the hospital's location. This section helps you find healthcare facilities that are included in your insurance network, ensuring that you receive the benefits your plan offers while seeking care. Data is available till 2025.

(0 Ratings)

Novant Health New Hanover Regional Medical Center

1313

Providers

769

No. of Beds

Specialties:

General Acute Care Hospital
+1 more

Location:

2131 S 17TH ST, WILMINGTON, NC 28401-7407

(0 Ratings)

Mission Hospital

1281

Providers

735

No. of Beds

Specialties:

General Acute Care Hospital
+1 more

Location:

509 BILTMORE AVE, ASHEVILLE, NC 28801-4601

(0 Ratings)

CONE HEALTH

1196

Providers

1262

No. of Beds

Specialties:

General Acute Care Hospital

Location:

1200 N ELM ST, GREENSBORO, NC 27401-1004

(0 Ratings)

CaroMont Regional Medical Center

638

Providers

442

No. of Beds

Specialties:

General Acute Care Hospital

Location:

2525 COURT DR, GASTONIA, NC 28054-2140

(0 Ratings)

AdventHealth Hendersonville

532

Providers

103

No. of Beds

Specialties:

General Acute Care Hospital - Rural

Location:

100 HOSPITAL DR, HENDERSONVILLE, NC 28792-5272

(0 Ratings)

ALAMANCE REGIONAL MEDICAL CENTER INC

457

Providers

238

No. of Beds

Specialties:

General Acute Care Hospital
+1 more

Location:

1240 HUFFMAN MILL RD, BURLINGTON, NC 27215

(0 Ratings)

CATAWBA MEMORIAL HOSPITAL

433

Providers

258

No. of Beds

Specialties:

General Acute Care Hospital

Location:

810 FAIRGROVE CHURCH RD, HICKORY, NC 28602-9617

(0 Ratings)

Novant Health Brunswick Medical Center

416

Providers

60

No. of Beds

Specialties:

General Acute Care Hospital

Location:

240 HOSPITAL DR NE, BOLIVIA, NC 28422-8346

(0 Ratings)

Frye Regional Medical Center

367

Providers

338

No. of Beds

Specialties:

General Acute Care Hospital
+4 more

Location:

420 N CENTER ST, STE 20, HICKORY, NC 28601-5046

(0 Ratings)

Haywood Regional Medical Center

244

Providers

178

No. of Beds

Specialties:

General Acute Care Hospital

Location:

262 LEROY GEORGE DR, CLYDE, NC 28721-7430

(0 Ratings)

Wilson Medical Center

225

Providers

407

No. of Beds

Specialties:

General Acute Care Hospital

Location:

1705 TARBORO ST SW, WILSON, NC 27893-3428

(0 Ratings)

Harris Regional Hospital

206

Providers

86

No. of Beds

Specialties:

General Acute Care Hospital

Location:

68 HOSPITAL RD, SYLVA, NC 28779-2722

+2974 more