Med Exp Bronze 10500 Health Deductible - HSA Eligible

SelectHealth, Inc. · 2027 plan year

Expanded BronzeHSA eligible

Ind. deductible: $10,500
Family deductible: $21,000
Ind. OOP max: $10,500
Family OOP max: $21,000

Other cost-sharing reduction variants for this plan:

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

More SelectHealth, Inc. plans in NV

Value Gold 1500 Medical Deductible - No deductible for office visits Value Silver 7500 Health Deductible - No deductible for office visits Value Exp Bronze 7500 Medical Deductible - HSA Eligible Value Exp Bronze 10500 Health Deductible - HSA Eligible

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Benefits & cost sharing

Primary Care

Benefit	In-network
Preventive Care/Screening/Immunization	No charge
Primary Care Visit to Treat an Injury or Illness	$45.00

Specialist

Benefit	In-network
Specialist Visit	$150.00

Hospital

Benefit	In-network
Emergency Room Services	No Charge after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	No Charge after deductible
Outpatient Surgery Physician/Surgical Services	No Charge after deductible
Urgent Care Centers or Facilities	$100.00

Pharmacy

Benefit	In-network
Generic Drugs	$40.00
Non-Preferred Brand Drugs	No Charge after deductible
Preferred Brand Drugs	No Charge after deductible
Specialty Drugs	No Charge after deductible

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	No Charge after deductible
Mental/Behavioral Health Outpatient Services	$55.00

Other

Benefit	In-network
Infertility Treatment	No Charge after deductible
Infusion Therapy	No Charge after deductible
Accidental Dental	No Charge after deductible
Allergy Testing	$150.00
Bariatric Surgery	No Charge after deductible
Chemotherapy	No Charge after deductible
Chiropractic Care	$45.00
Delivery and All Inpatient Services for Maternity Care	No Charge after deductible
Diabetes Education	$45.00
Dialysis	No Charge after deductible
Durable Medical Equipment	No Charge after deductible
Emergency Transportation/Ambulance	No Charge after deductible
Eye Glasses for Children	No charge
Gender Affirming Care	No Charge after deductible
Habilitation Services	No Charge after deductible
Hearing Aids	No Charge after deductible
Home Health Care Services	No Charge after deductible
Hospice Services	No Charge after deductible
Imaging (CT/PET Scans, MRIs)	No Charge after deductible
Inpatient Physician and Surgical Services	No Charge after deductible
Laboratory Outpatient and Professional Services	$65.00
Nutritional Counseling	$45.00
Other Practitioner Office Visit (Nurse, Physician Assistant)	$45.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	No Charge after deductible
Outpatient Rehabilitation Services	$100.00
Prenatal and Postnatal Care	$45.00
Private-Duty Nursing	No Charge after deductible
Prosthetic Devices	No Charge after deductible
Radiation	No Charge after deductible
Reconstructive Surgery	No Charge after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	No Charge after deductible
Rehabilitative Speech Therapy	No Charge after deductible
Routine Eye Exam for Children	No charge
Skilled Nursing Facility	No Charge after deductible
Substance Abuse Disorder Inpatient Services	No Charge after deductible
Substance Abuse Disorder Outpatient Services	$55.00
Transplant	No Charge after deductible
Treatment for Temporomandibular Joint Disorders	No Charge after deductible
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	$100.00

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