Standard Platinum: WellSense Clarity Platinum 0 Deductible
WellSense Health Plan MA · 2027 plan year
Platinum
- Ind. deductible
- $0
- Family deductible
- $0
- Ind. OOP max
- $3,500
- Family OOP max
- $7,000
Compare with other Platinum plans in MA
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More WellSense Health Plan MA plans in MA
Monthly premiums by age
Rating Area 1 — the lowest-priced of the 7 areas this plan covers. Premiums differ by area.
| Age | Individual |
|---|---|
| Under 15 | $452 |
| 21 | $712 |
| 30 | $775 |
| 40 | $839 |
| 50 | $1,048 |
| 60 | $1,424 |
| 64 and over | $1,424 |
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 | $25.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $45.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | $200.00 |
| Inpatient Hospital Services (e.g., Hospital Stay) | $500.00 Copay per Stay |
| Outpatient Surgery Physician/Surgical Services | No charge |
| Urgent Care Centers or Facilities | $45.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Specialty Drugs | $60.00 |
| Generic Drugs | $20.00 |
| Non-Preferred Brand Drugs | $60.00 |
| Preferred Brand Drugs | $40.00 |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | $500.00 Copay per Stay |
| Mental/Behavioral Health Outpatient Services | $25.00 |
Other
| Benefit | In-network |
|---|---|
| Allergy Testing | $45.00 |
| Bariatric Surgery | $250.00 |
| Abortion for Which Public Funding is Prohibited | No charge |
| Acupuncture | $25.00 |
| Basic Dental Care - Child | 25.00% Coinsurance after deductible |
| Chemotherapy | No charge |
| Chiropractic Care | $45.00 |
| Delivery and All Inpatient Services for Maternity Care | $500.00 |
| Dental Check-Up for Children | No charge |
| Diabetes Education | No charge |
| Dialysis | No charge |
| Durable Medical Equipment | 20.00% |
| Emergency Transportation/Ambulance | No charge |
| Eye Glasses for Children | 20.00% |
| Habilitation Services | $45.00 |
| Hearing Aids | 20.00% |
| Home Health Care Services | No charge |
| Hospice Services | No charge |
| Imaging (CT/PET Scans, MRIs) | $200.00 |
| Infertility Treatment | $45.00 |
| Infusion Therapy | No charge |
| Inpatient Physician and Surgical Services | No charge |
| Laboratory Outpatient and Professional Services | $25.00 |
| Major Dental Care - Child | 50.00% Coinsurance after deductible |
| Nutritional Counseling | $45.00 |
| Orthodontia - Child | 50.00% |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $25.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | $250.00 |
| Outpatient Rehabilitation Services | $45.00 |
| Prenatal and Postnatal Care | No charge |
| Prosthetic Devices | 20.00% |
| Radiation | No charge |
| Reconstructive Surgery | $500.00 |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $45.00 |
| Rehabilitative Speech Therapy | $45.00 |
| Routine Eye Exam (Adult) | $45.00 |
| Routine Eye Exam for Children | $45.00 |
| Routine Foot Care | $45.00 |
| Skilled Nursing Facility | $500.00 Copay per Stay |
| Substance Abuse Disorder Inpatient Services | $500.00 Copay per Stay |
| Substance Abuse Disorder Outpatient Services | $25.00 |
| Transplant | $500.00 |
| Treatment for Temporomandibular Joint Disorders | $45.00 |
| Weight Loss Programs | 75.00% |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $25.00 |
Service area
This plan covers 17 geographic areas. 7 of them are covered only in part, meaning specific ZIP codes rather than the whole county. The filing does not list which, so confirm with the insurer or on HealthCare.gov before enrolling.
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