Wellmark Bronze High-Deductible Health PlanSM*
If you have a good understanding of your future medical needs and want to use a health savings account (HSA) Glossary popover, consider a high-deductible health plan (HDHP).
High-deductible health plans (HDHP) put you in the driver's seat by giving you more control of your health care costs. Because you pay the full cost of care received (excluding preventive care) and prescriptions until you reach your deductible, an HDHP encourages engagement in your health care.
With a bronze tier, overall Wellmark pays about 60 percent and you'll 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.
|Plan Details||Wellmark Bronze HDHP HMOSM|
|Premium||View on HealthCare.gov External Site|
|Network: Wellmark Blue HMOSM||View in-network providers External SiteEnter your location, browse a list of plans and choose Wellmark Blue HMO.|
|Deductible and out-of-pocket maximum||Individual: $7,000|
|Free1: Preventive Care||Free|
|Lowest Cost: Virtual visit through Doctor On Demand®2||$|
|Low cost: Primary care provider office visit, facility lab/X-ray, urgent care||$|
|Medium cost: Specialist office visit, outpatient physical therapist, home health care||$$|
|High cost: Emergency room, ambulatory, inpatient hospitalization||$$$|
|Prescription drugs: Blue Rx EssentialsSM Formulary/CVS Specialty® Program||All tiers: deductible applies (medical/drug deductible)|
Prescription costs matter
With a Wellmark Bronze HDHP HMOSM plan, your pharmacy benefits are easy to navigate with Blue Rx EssentialsSM. You'll know exactly what you'll pay without any hidden costs or fees. Search the drug list External Site to check current or anticipated prescriptions.
Drug tier 1 has the lowest payment obligation. It includes most generics and select branded drugs that have no generic equivalent.
Drug tier 2 has a higher payment obligation than Tier 1 and is made up of drugs that are preferred based on effectiveness when compared to similar drugs.
Drug tier 3 also increases out-of-pocket costs. It consists of non-preferred drugs that have reasonable, more cost-effective alternatives on Tier 1 or Tier 2.
Biosimilar and generic specialty drugs are safe, effective and less costly than specialty treatment options. According to the Food and Drug Administration (FDA), a biosimilar is highly similar to and has no meaningful differences from an existing FDA-approved product.
Specialty drugs are split into two categories — preferred and non-preferred. Preferred drugs are proven to treat complex or rare conditions.