Bronze EPO $0 Health $50 PCP 10025
Alliant Health Plans, Inc. · 2027 plan year
Expanded BronzeHSA eligible
- Ind. deductible
- $0
- Family deductible
- $0
- Ind. OOP max
- $12,000
- Family OOP max
- $24,000
Compare with other Expanded Bronze plans in TN
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More Alliant Health Plans, Inc. plans in TN
Monthly premiums by age
Rating Area 3
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $415 | $415 |
| 21 | $542 | $569 |
| 30 | $616 | $646 |
| 40 | $693 | $728 |
| 50 | $969 | $1,017 |
| 60 | $1,472 | $1,545 |
| 64 and over | $1,627 | $1,708 |
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 | $50.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $160.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | $3,000.00 |
| Inpatient Hospital Services (e.g., Hospital Stay) | $3000.00 Copay per Stay |
| Outpatient Surgery Physician/Surgical Services | $750.00 |
| Urgent Care Centers or Facilities | $50.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $10.00 |
| Non-Preferred Brand Drugs | 40.00% |
| Preferred Brand Drugs | 40.00% |
| Specialty Drugs | 50.00% |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | $3000.00 Copay per Stay |
| Mental/Behavioral Health Outpatient Services | $50.00 |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | 40.00% |
| Acupuncture | Not covered |
| Allergy Testing | 40.00% |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | Not covered |
| Chemotherapy | 40.00% |
| Chiropractic Care | $50.00 |
| Cosmetic Surgery | 40.00% |
| Delivery and All Inpatient Services for Maternity Care | $3,000.00 |
| Dental Check-Up for Children | Not covered |
| Diabetes Education | 40.00% |
| Dialysis | 40.00% |
| Durable Medical Equipment | 40.00% |
| Emergency Transportation/Ambulance | $3,000.00 |
| Eye Glasses for Children | 40.00% |
| Habilitation Services | $150.00 |
| Hearing Aids | 40.00% |
| Home Health Care Services | 40.00% |
| Hospice Services | 40.00% |
| Imaging (CT/PET Scans, MRIs) | $500.00 |
| Infertility Treatment | Not covered |
| Infusion Therapy | 40.00% |
| Inpatient Physician and Surgical Services | 40.00% |
| Laboratory Outpatient and Professional Services | $125.00 |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | Not covered |
| Nutritional Counseling | 40.00% |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | Not covered |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $50.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | $500.00 |
| Outpatient Rehabilitation Services | $150.00 |
| Prenatal and Postnatal Care | $50.00 |
| Private-Duty Nursing | Not covered |
| Prosthetic Devices | 40.00% |
| Radiation | 40.00% |
| Reconstructive Surgery | 40.00% |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $150.00 |
| Rehabilitative Speech Therapy | $150.00 |
| Routine Dental Services (Adult) | Not covered |
| Routine Eye Exam (Adult) | Not covered |
| Routine Eye Exam for Children | 40.00% |
| Routine Foot Care | Not covered |
| Skilled Nursing Facility | $750.00 Copay per Stay |
| Substance Abuse Disorder Inpatient Services | $3,000.00 |
| Substance Abuse Disorder Outpatient Services | $50.00 |
| Transplant | 40.00% |
| Treatment for Temporomandibular Joint Disorders | 40.00% |
| Weight Loss Programs | 40.00% |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $150.00 |
Plan rules
Service area
This plan covers 11 geographic areas.
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