Bronze health plan options
2022 ACA Plan Comparison Guide | South Dakota Small Group Plans
With a bronze tier, overall Wellmark pays about 60 percent and your employees will pay about 40 percent of the plan's cost-sharing requirements, which can include the deductible, coinsurance and copays. Consider a bronze plan if you want lower monthly premiums compared to gold and silver plans.
Bronze plan details
All of our members in South Dakota use the Wellmark Blue PPOSM Network which gives them access to more than 1.7 million unique, in-network health care providers throughout the United States1. Amounts in the table reflect covered, in-network services only. All plans include easy-to-navigate pharmacy benefits with Blue Rx EssentialsSM. Blue Rx Essentials prescription tiers are designated based on factors like cost and effectiveness when compared to similar drugs.
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|myBlue HDHPSM Bronze||SimplyBlueSM Modified||SimplyBlueSM 6000||SimplyBlueSM Primary|
|Medical deductible — annual amount you pay before Wellmark pays|
|Coinsurance — portion of medical cost you pay after your deductible is met||0%||0%||50%||50%|
|Out-of-pocket maximum (OPM) — the most you'll spend in a year|
|Preventive care screenings||Free||Free||Free||Free|
|Primary care office services||$80||$70||$20|
|Non-primary care office services||$160||$150||$150|
|Emergency room visit||$1,000||Deductible plus 50% coinsurance||Deductible plus 50% coinsurance|
|Pharmacy benefits — Blue Rx EssentialsSM|
|Tier 2||Deductible||Deductible plus 50% coinsurance||Deductible plus 50% coinsurance|
|Biosimilar and generic specialty|
|Qualifies for health savings account (HSA)||Yes||No||No||No|
|Medicare Part D Creditable Coverage||No||No||No||No|
1 Provider Data Repository (PDR), January 2021. From national BlueCard PPO portion of the network reporting services (NRS) extract of PDR data. The data is limited to records in Plans' licensed service.