UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals)

69461AL0110020
Expanded Bronze
EPO

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) is an Expanded Bronze EPO plan by UnitedHealthcare.

IMPORTANT: You are viewing the 2024 version of UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) 69461AL0110020. You can enroll in this plan during open enrollment 2024, which starts November 1st and ends January 15th, 2023, in most states.

Locations

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) is offered in the following counties.

Plan Overview

This is a plan overview for 2024 version of UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) 69461AL0110020.
Insurer: UnitedHealthcare
Network Type: EPO
Metal Type: Expanded Bronze
HSA Eligible?: No
Plan ID: 69461AL0110020

Cost-Sharing Overview

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) offers the following cost-sharing.

Notes:

  • Some plans have separate cost-sharing for medical and drugs, while other plans offer combined cost-sharing. The cost-sharing amounts above are combined medical and drug costs unless otherwise noted.
  • You are viewing the standard version of this plan. Your costs may be lower depending on your income. Use the “get a quote” button below to see your estimated premium and out-of-pocket costs after assistance.
Ready to sign up for UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals)?

Click or call to enroll online, get a quote, or find out if you qualify for assistance.
Get Help from a licensed agent. 1-877-668-0904

Plan Features

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) offers the following features and referral requirements.

Wellness Program: No
Disease Program:
Notice Pregnancy: No
Referral Specialist: No
Specialist Requiring Referral:
Plan Exclusions:
Child Only Option?: Allows Adult and Child-Only

Network Details

The following network details will help you understand what UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) covers when you are out of the service area or out of the country.

Out of Country Coverage: No
Out of Country Coverage Description:
Out of Service Area Coverage: Yes
Out of Service Area Coverage Description: Plan covers eligible expenses provided by a Network Physician or other provider or facility within the Network Area. The Network Area may include select Network providers located in a neighboring state.
National Network: No

Additional Benefits and Cost-Sharing

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) includes the following benefits at the cost sharing rates listed below.

Service In-Network
Copay / Coinsurance
Out-of-Network
Copay / Coinsurance
Limits and Explanation
Primary Care Visit to Treat an Injury or Illness
Covered
$50.00 Not ApplicableNot Applicable 100.00% Cost sharing for Virtual Primary Care matches in-person office visit. See SBC for additional cost share details.
Specialist Visit
Covered
$150.00 Not ApplicableNot Applicable 100.00%
Other Practitioner Office Visit (Nurse, Physician Assistant)
Covered
Not Applicable 50.00%Not Applicable 100.00%
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Covered
$375.00 Not ApplicableNot Applicable 100.00%
Outpatient Surgery Physician/Surgical Services
Covered
$375.00 Not ApplicableNot Applicable 100.00%
Hospice Services
Covered
Not Applicable 50.00%Not Applicable 100.00%
Routine Dental Services (Adult)
Not Covered
Infertility Treatment
Not Covered
Long-Term/Custodial Nursing Home Care
Not Covered
Private-Duty Nursing
Not Covered
Routine Eye Exam (Adult)
Not Covered
Urgent Care Centers or Facilities
Covered
$100.00 Not ApplicableNot Applicable 100.00% $0 Virtual Urgent Care visits. See SBC for additional cost share details.
Home Health Care Services
Covered
Not Applicable 50.00%Not Applicable 100.00%60.0 Visit(s) per Year
Emergency Room Services
Covered
$2,000.00 Not Applicable$2,000.00 Not Applicable
Emergency Transportation/Ambulance
Covered
Not Applicable 50.00%Not Applicable 50.00%
Inpatient Hospital Services (e.g., Hospital Stay)
Covered
$3000 Copay per Day Not ApplicableNot Applicable 100.00%
Inpatient Physician and Surgical Services
Covered
Not Applicable 50.00%Not Applicable 100.00%
Bariatric Surgery
Not Covered
Cosmetic Surgery
Not Covered
Skilled Nursing Facility
Covered
$3000 Copay per Day Not ApplicableNot Applicable 100.00%60.0 Days per Year Limit will be any combination of Skilled Nursing Facility or Inpatient Rehabilitation Facility Services.
Prenatal and Postnatal Care
Covered
Not Applicable No ChargeNot Applicable 100.00%
Delivery and All Inpatient Services for Maternity Care
Covered
$3,000.00 Not ApplicableNot Applicable 100.00% Childbirth/delivery professional services follow inpatient physician/surgeon fees.
Mental/Behavioral Health Outpatient Services
Covered
$100.00 Not ApplicableNot Applicable 100.00%
Mental/Behavioral Health Inpatient Services
Covered
$3000 Copay per Day Not ApplicableNot Applicable 100.00%
Substance Abuse Disorder Outpatient Services
Covered
$100.00 Not ApplicableNot Applicable 100.00%
Substance Abuse Disorder Inpatient Services
Covered
$3000 Copay per Day Not ApplicableNot Applicable 100.00%
Generic Drugs
Covered
$25.00 Not ApplicableNot Applicable 100.00%30.0 Days per Month
Preferred Brand Drugs
Covered
Not Applicable 40% Coinsurance after deductibleNot Applicable 100.00%30.0 Days per Month
Non-Preferred Brand Drugs
Covered
Not Applicable 45% Coinsurance after deductibleNot Applicable 100.00%30.0 Days per Month
Specialty Drugs
Covered
Not Applicable 50% Coinsurance after deductibleNot Applicable 100.00%30.0 Days per Month Covers outpatient self-administered prescription legend drugs from a participating network pharmacy. Quantity limits per prescription may apply.
Outpatient Rehabilitation Services
Covered
$100.00 Not ApplicableNot Applicable 100.00%30.0 Visit(s) per Year 30 visits for any combination of physical therapy, occupational therapy and speech therapy.
Habilitation Services
Covered
$100.00 Not ApplicableNot Applicable 100.00%30.0 Visit(s) per Year 30 visits for any combination of physical therapy, occupational therapy and speech therapy
Chiropractic Care
Covered
Not Applicable 50.00%Not Applicable 100.00%10.0 Visit(s) per Year
Durable Medical Equipment
Covered
Not Applicable 50.00%Not Applicable 100.00%
Hearing Aids
Not Covered
Imaging (CT/PET Scans, MRIs)
Covered
$200.00 Not ApplicableNot Applicable 100.00%
Preventive Care/Screening/Immunization
Covered
Not Applicable No ChargeNot Applicable 100.00%
Routine Foot Care
Not Covered
Acupuncture
Not Covered
Weight Loss Programs
Not Covered
Routine Eye Exam for Children
Covered
Not Applicable No ChargeNot Applicable 100.00%1.0 Visit(s) per Year
Eye Glasses for Children
Covered
Not Applicable 50.00%Not Applicable 100.00%1.0 Item(s) per Year
Dental Check-Up for Children
Covered
Not Applicable No ChargeNot Applicable 100.00%1.0 Visit(s) per 6 Months
Rehabilitative Speech Therapy
Covered
$100.00 Not ApplicableNot Applicable 100.00%30.0 Visit(s) per Year 30 visits for any combination of physical therapy, occupational therapy and speech therapy.
Rehabilitative Occupational and Rehabilitative Physical Therapy
Covered
$100.00 Not ApplicableNot Applicable 100.00%30.0 Visit(s) per Year 30 visits for any combination of physical therapy, occupational therapy and speech therapy.
Well Baby Visits and Care
Covered
Not Applicable No ChargeNot Applicable 100.00%
Laboratory Outpatient and Professional Services
Covered
$20.00 Not ApplicableNot Applicable 100.00%
X-rays and Diagnostic Imaging
Covered
$100.00 Not ApplicableNot Applicable 100.00%
Basic Dental Care – Child
Covered
Not Applicable 50.00%Not Applicable 100.00% Benefit limitations may apply to individual services.
Orthodontia – Child
Covered
Not Applicable 50.00%Not Applicable 100.00% Coverage is for medically necessary orthodontia only.
Major Dental Care – Child
Covered
Not Applicable 50.00%Not Applicable 100.00% Benefit limitations may apply to individual services.
Basic Dental Care – Adult
Not Covered
Orthodontia – Adult
Not Covered
Major Dental Care – Adult
Not Covered
Abortion for Which Public Funding is Prohibited
Not Covered
Transplant
Covered
$3,000.00 Not ApplicableNot Applicable 100.00%
Accidental Dental
Covered
Not Applicable 50.00%Not Applicable 100.00%
Dialysis
Covered
Not Applicable 50.00%Not Applicable 100.00%
Allergy Testing
Covered
$150.00 Not ApplicableNot Applicable 100.00%
Chemotherapy
Covered
Not Applicable 50.00%Not Applicable 100.00%
Radiation
Covered
Not Applicable 50.00%Not Applicable 100.00%
Diabetes Education
Covered
Not Applicable 50.00%Not Applicable 100.00%
Prosthetic Devices
Covered
Not Applicable 50.00%Not Applicable 100.00%
Infusion Therapy
Covered
Not Applicable 50.00%Not Applicable 100.00%
Treatment for Temporomandibular Joint Disorders
Not Covered
Nutritional Counseling
Not Covered
Reconstructive Surgery
Covered
$375.00 Not ApplicableNot Applicable 100.00%
Gender Affirming Care
Not Covered

Free Preventive Services

There is no copayment or coinsurance for any of the following UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) preventive services. This is true even if you haven’t met your yearly deductible.

Please note, these services are free only when delivered by a doctor or other provider in your plan’s network.

Additional Resources

Below are additional resources for UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals) including the Summary of Benefits & Coverage (SBC), plan brochure, formulary link, and a link to the website to pay your monthly premium after you enroll.

Summary of Benefits: Summary of Benefits Link
Plan Brochure: Plan Brochure Link
Formulary: Formulary Link
Premium Payment Website: Premium Payment Link
Ready to sign up for UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $0 Insulin, No Referrals)?

Click or call to enroll online, get a quote, or find out if you qualify for assistance.
Get Help from a licensed agent. 1-877-668-0904

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