Sold outside the marketplace. This plan is bought directly from the insurer, so it is not eligible for a premium tax credit. If your income qualifies you for savings, a marketplace plan at the same price will usually cost you less.

Wellpoint Essential Bronze 5500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives)

Wellpoint · 2026 plan year

Expanded BronzeHSA eligible
Ind. deductible
$5,500
Family deductible
$11,000
Ind. OOP max
$10,600
Family OOP max
$21,200

More Wellpoint plans in FL

Monthly premiums by age

Rating Area 28 — the lowest-priced of the 24 areas this plan covers. Premiums differ by area.

AgeIndividual
Under 15$312
21$408
30$463
40$521
50$729
60$1,107
64 and over$1,224

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 Visit35.00% Coinsurance after deductible

Hospital

BenefitIn-network
Emergency Room Services$500.00 Copay after deductible + 50.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)$500.00 Copay per Stay after deductible + 50.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services35.00% Coinsurance after deductible
Urgent Care Centers or Facilities$60.00

Pharmacy

BenefitIn-network
Generic Drugs$25.00
Non-Preferred Brand Drugs45.00% Coinsurance after deductible
Preferred Brand Drugs40.00% Coinsurance after deductible
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services$500.00 Copay per Stay after deductible + 50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services35.00% Coinsurance after deductible

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental35.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing35.00% Coinsurance after deductible
Bariatric SurgeryNot covered
Basic Dental Care - Adult40.00%
Basic Dental Care - ChildNot covered
Chemotherapy35.00% Coinsurance after deductible
Chiropractic Care35.00% Coinsurance after deductible
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care$500.00 Copay after deductible + 50.00% Coinsurance after deductible
Dental Check-Up for ChildrenNot covered
Diabetes Education35.00% Coinsurance after deductible
Dialysis35.00% Coinsurance after deductible
Durable Medical Equipment35.00% Coinsurance after deductible
Emergency Transportation/Ambulance35.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Habilitation Services35.00% Coinsurance after deductible
Hearing AidsNot covered
Home Health Care Services35.00% Coinsurance after deductible
Hospice Services35.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)50.00% Coinsurance after deductible
X-rays and Diagnostic Imaging35.00% Coinsurance after deductible
Infertility Treatment35.00% Coinsurance after deductible
Infusion Therapy35.00% Coinsurance after deductible
Inpatient Physician and Surgical Services35.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services35.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - Adult50.00%
Major Dental Care - ChildNot covered
Nutritional Counseling35.00% Coinsurance after deductible
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$30.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)35.00% Coinsurance after deductible
Outpatient Rehabilitation Services35.00% Coinsurance after deductible
Prenatal and Postnatal CareNo charge
Private-Duty NursingNot covered
Prosthetic Devices35.00% Coinsurance after deductible
Radiation35.00% Coinsurance after deductible
Reconstructive Surgery$500.00 Copay after deductible + 50.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy35.00% Coinsurance after deductible
Rehabilitative Speech Therapy35.00% Coinsurance after deductible
Routine Dental Services (Adult)No charge
Routine Eye Exam (Adult)$20.00
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility35.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services$500.00 Copay per Stay after deductible + 50.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services35.00% Coinsurance after deductible
Transplant$500.00 Copay after deductible + 50.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders35.00% Coinsurance after deductible
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge

Service area

This plan covers 24 geographic areas.

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