Medica with CHI Health Bronze Premier + Adult Eye Exam

Medica · 2026 plan year

Expanded BronzeHSA eligible

Ind. deductible: $2,000
Family deductible: $4,000
Ind. OOP max: $10,600
Family OOP max: $21,200

Compare with other Expanded Bronze plans in NE

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

Elite BronzeAmbetter Health · Deductible $0 medical + $3,800 Rx (separate) · Out-of-pocket max $10,500
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)UnitedHealthcare · Deductible $0 medical + $4,500 Rx (separate) · Out-of-pocket max $10,600
Bronze Elite + PCP Saver PlusOscar Insurance Company · Deductible $0 medical + $7,000 Rx (separate) · Out-of-pocket max $10,600

Compare 4 plans Browse all Expanded Bronze plans in NE

Other cost-sharing reduction variants for this plan:

Limited Cost Sharing Plan Variation Standard Bronze Off Exchange Plan Zero Cost Sharing Plan Variation

More Medica plans in NE

Medica Insure Silver Standard Medica Insure Gold Share

Monthly premiums by age

Rating Area 1 — the lowest-priced of the 3 areas this plan covers. Premiums differ by area.

Age	Individual	Individual + tobacco
Under 15	$406	$406
21	$531	$562
30	$602	$638
40	$678	$719
50	$948	$1,005
60	$1,440	$1,526
64 and over	$1,592	$1,687

Live premium estimate

Benefits & cost sharing

Primary Care

Benefit	In-network
Preventive Care/Screening/Immunization	No charge
Primary Care Visit to Treat an Injury or Illness	No Charge after deductible

Specialist

Benefit	In-network
Specialist Visit	$160.00 Copay after deductible

Hospital

Benefit	In-network
Inpatient Hospital Services (e.g., Hospital Stay)	50.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	50.00% Coinsurance after deductible
Emergency Room Services	50.00% Coinsurance after deductible
Urgent Care Centers or Facilities	No Charge after deductible

Pharmacy

Benefit	In-network
Non-Preferred Brand Drugs	50.00% Coinsurance after deductible
Preferred Brand Drugs	$200.00
Generic Drugs	$35.00
Specialty Drugs	60.00% Coinsurance after deductible

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	No Charge after deductible

Other

Benefit	In-network
Home Health Care Services	50.00% Coinsurance after deductible
Hospice Services	50.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	50.00% Coinsurance after deductible
Infertility Treatment	Not covered
Infusion Therapy	50.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	50.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	50.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home Care	Not covered
Major Dental Care - Adult	Not covered
Major Dental Care - Child	Not covered
Nutritional Counseling	50.00% Coinsurance after deductible
Orthodontia - Adult	Not covered
Orthodontia - Child	Not covered
Other Practitioner Office Visit (Nurse, Physician Assistant)	No Charge after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	50.00% Coinsurance after deductible
Outpatient Rehabilitation Services	50.00% Coinsurance after deductible
Prenatal and Postnatal Care	50.00% Coinsurance after deductible
Private-Duty Nursing	Not covered
Prosthetic Devices	50.00% Coinsurance after deductible
Radiation	50.00% Coinsurance after deductible
Reconstructive Surgery	50.00% Coinsurance after deductible
Hearing Aids	50.00% Coinsurance after deductible
Abortion for Which Public Funding is Prohibited	Not covered
Accidental Dental	50.00% Coinsurance after deductible
Acupuncture	Not covered
Allergy Testing	50.00% Coinsurance after deductible
Bariatric Surgery	Not covered
Basic Dental Care - Adult	Not covered
Basic Dental Care - Child	Not covered
Chemotherapy	$160.00 Copay after deductible
Chiropractic Care	No Charge after deductible
Cosmetic Surgery	Not covered
Delivery and All Inpatient Services for Maternity Care	50.00% Coinsurance after deductible
Dental Check-Up for Children	Not covered
Diabetes Education	No charge
Dialysis	50.00% Coinsurance after deductible
Durable Medical Equipment	50.00% Coinsurance after deductible
Emergency Transportation/Ambulance	50.00% Coinsurance after deductible
Eye Glasses for Children	50.00% Coinsurance after deductible
Habilitation Services	50.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	50.00% Coinsurance after deductible
Rehabilitative Speech Therapy	50.00% Coinsurance after deductible
Routine Dental Services (Adult)	Not covered
Routine Eye Exam (Adult)	No Charge after deductible
Routine Eye Exam for Children	No Charge after deductible
Routine Foot Care	Not covered
Skilled Nursing Facility	50.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	50.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	No Charge after deductible
Transplant	50.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	50.00% Coinsurance after deductible
Weight Loss Programs	Not covered
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	50.00% Coinsurance after deductible