Can someone please help me make sense of this NY Marketplace plan and if it’s any good?
I am zeroing in on this marketplace plan, and I am not sure if it means what I think it means. Can someone please help me understand? Here are the details. Am I understanding this correct that I need to meet that enormous deductible before I qualify for the copay? And until then I have to pay the full amount the provider bills me? I am so confused.
|| || |Quality Details|Anthem Gatekeeper X, Bronze, ST, INN, Individual Network, Dep 25, Pediatric Dental|Bronze|Medical Plus Child Dental|New York|Individual|$704.06|
Price Per Month $704.06 Metal Bronze Overall Quality Rating Quality Details Maximum Out of Pocket $9,450 / $9450 per person $18900 per group Out-of-Network Coverage No Allows Health Savings Account Plan Id 41046NY0010038 Persons Covered Individual Deductible $4,600 / $4600 per person Specialist(s) Referral Required Yes Referral(s) Required All specialists require referral with the exception of OB/GYN
|| || |Primary Care Visit to Treat an Injury or Illness|$50.00 Copay after deductible|100.00%|1st office visit with copayment not subject to deductible. Subsequent visits with Copayment after Deductible. Office visit Copayment limit is combined for visits In Office, Telehealth, Telemedicine, Outpatient Mental Healthcare and Outpatient Substance Services|
|| || |Applied Behavior Analysis Based Therapies|$50.00 Copay after deductible|100.00%|3 office visit with copayment not subject to deductible. Subsequent visits with Copayment after Deductible. Office visit Copayment limit is combined for visits In Office, Telehealth, Telemedicine, Outpatient Mental Healthcare and Outpatient Substance Services|
submitted by /u/lafleurdoranger
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