Bronze $8,300 w/ Adult Dental ON-EX

MedMutual · 2026 plan year

Expanded BronzeHSA eligible
Ind. deductible
$8,300
Family deductible
$16,600
Ind. OOP max
$10,000
Family OOP max
$20,000

Compare with other Expanded Bronze plans in OH

Side by side: deductibles, out-of-pocket limits and copays.

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Monthly premiums by age

Rating Area 3 — the lowest-priced of the 17 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$238$238
21$311$326
30$353$388
40$397$457
50$555$638
60$843$970
64 and over$932$1,072

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$30.00

Specialist

BenefitIn-network
Specialist Visit$110.00

Hospital

BenefitIn-network
Emergency Room Services50.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)50.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services50.00% Coinsurance after deductible
Urgent Care Centers or Facilities$50.00

Pharmacy

BenefitIn-network
Generic DrugsNo charge
Non-Preferred Brand Drugs50.00% Coinsurance after deductible
Preferred Brand Drugs50.00% Coinsurance after deductible
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$30.00

Other

BenefitIn-network
Delivery and All Inpatient Services for Maternity Care50.00% Coinsurance after deductible
Dental Check-Up for ChildrenNo charge
Diabetes EducationNo charge
Dialysis50.00% Coinsurance after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)50.00% Coinsurance after deductible
X-rays and Diagnostic Imaging50.00% Coinsurance after deductible
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental50.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing50.00% Coinsurance after deductible
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNo charge
Chemotherapy50.00% Coinsurance after deductible
Chiropractic Care$30.00
Cosmetic SurgeryNot covered
Durable Medical Equipment50.00% Coinsurance after deductible
Emergency Transportation/Ambulance50.00% Coinsurance after deductible
Eye Glasses for Children50.00% Coinsurance after deductible
Habilitation Services$30.00
Hearing AidsNo charge
Home Health Care Services50.00% Coinsurance after deductible
Hospice Services50.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)50.00% Coinsurance after deductible
Infertility Treatment50.00% Coinsurance after deductible
Infusion Therapy50.00% Coinsurance after deductible
Inpatient Physician and Surgical Services50.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services50.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNo charge
Nutritional Counseling50.00% Coinsurance after deductible
Orthodontia - AdultNot covered
Orthodontia - ChildNo charge
Other Practitioner Office Visit (Nurse, Physician Assistant)$30.00
Outpatient Rehabilitation Services50.00% Coinsurance after deductible
Prenatal and Postnatal Care50.00% Coinsurance after deductible
Private-Duty Nursing50.00% Coinsurance after deductible
Prosthetic Devices50.00% Coinsurance after deductible
Radiation50.00% Coinsurance after deductible
Reconstructive Surgery50.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$30.00
Rehabilitative Speech Therapy$30.00
Routine Dental Services (Adult)No charge
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility50.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services50.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$30.00
Transplant50.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders50.00% Coinsurance after deductible
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge

Plan rules

Service area

This plan covers 1 geographic area.

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