Select Health - SelectHealth Expanded Bronze 8550 - no deductible for office visits
Primary Care Visit
$45 Copay
50% Coinsurance after deductible
Specialist Visit
$90 Copay
50% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)
$45 Copay
50% Coinsurance after deductible
Preventive Care/Screening/Immunization
No Charge
50% Coinsurance after deductible
Laboratory Outpatient and Professional Services
No Charge after deductible
50% Coinsurance after deductible
X-rays and Diagnostic Imaging
No Charge after deductible
50% Coinsurance after deductible
Imaging (CT/PET scans, MRIs)
No Charge after deductible
50% Coinsurance after deductible
Generic Drugs
$20 Copay
$20 Copay
Preferred Brand Drugs
No Charge after deductible
No Charge after deductible
Non-Preferred Brand Drugs
No Charge after deductible
No Charge after deductible
Specialty Drugs
No Charge after deductible
No Charge after deductible
Outpatient Facility Fee
No Charge after deductible
50% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services
No Charge after deductible
50% Coinsurance after deductible
Emergency Room Services
No Charge after deductible
No Charge after deductible
Emergency Transportation/Ambulance
No Charge after deductible
No Charge after deductible
Urgent Care
$90 Copay
50% Coinsurance after deductible
Inpatient Hospital Services
No Charge after deductible
50% Coinsurance after deductible
Inpatient Physician and Surgical Services
No Charge after deductible
50% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services
No Charge after deductible
50% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services
No Charge after deductible
50% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services
No Charge after deductible
50% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services
No Charge after deductible
50% Coinsurance after deductible
Prenatal and Postnatal Care
No Charge after deductible
50% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care
No Charge after deductible
50% Coinsurance after deductible
Home Healthcare Services
No Charge after deductible
50% Coinsurance after deductible
Outpatient Rehabilitation Services
No Charge after deductible
50% Coinsurance after deductible
Habilitation Services
No Charge after deductible
50% Coinsurance after deductible
Skilled Nursing Facility
No Charge after deductible
50% Coinsurance after deductible
Durable Medical Equipment
No Charge after deductible
50% Coinsurance after deductible
Hospice Services
No Charge after deductible
50% Coinsurance after deductible
Chiropractic Care
No Charge after deductible
50% Coinsurance after deductible
Acupuncture
Not covered
Not covered
Rehabilitative Speech Therapy
No Charge after deductible
50% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy
No Charge after deductible
50% Coinsurance after deductible
Well Baby Visits and Care
No Charge
50% Coinsurance after deductible
Allergy Testing
$90 Copay
50% Coinsurance after deductible
Diabetes Education
No Charge
50% Coinsurance after deductible
Nutritional Counseling
No Charge
50% Coinsurance after deductible
Eye Exam for Children
$90 Copay
50% Coinsurance after deductible
Eye Glasses for Children
No Charge after deductible
50% Coinsurance after deductible
Accidental Dental
No Charge after deductible
50% Coinsurance after deductible
Basic Dental Care (Adult)
Not covered
Not covered
Basic Dental Care (Child)
Not covered
Not covered
Dental Check Up (Child)
Not covered
Not covered
Major Dental Care (Adult)
Not covered
Not covered
Major Dental Care (Child)
Not covered
Not covered
Orthodontia (Adult)
Not covered
Not covered
Orthodontia (Child)
Not covered
Not covered
Routine Dental Services (Adult)
Not covered
Not covered