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.

Standard High Bronze HSA - Flex

Harvard Pilgrim Health Care, Inc. · 2027 plan year

Expanded BronzeHSA eligible
Ind. deductible
$5,000
Family deductible
$10,000
Ind. OOP max
$8,700
Family OOP max
$17,400

More Harvard Pilgrim Health Care, Inc. plans in MA

Monthly premiums by age

Rating Area 1 — the lowest-priced of the 7 areas this plan covers. Premiums differ by area.

AgeIndividual
Under 15$337
21$530
30$577
40$624
50$780
60$1,060
64 and over$1,060

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$50.00 Copay after deductible

Specialist

BenefitIn-network
Specialist Visit$80.00 Copay after deductible

Hospital

BenefitIn-network
Emergency Room Services$750.00 Copay after deductible
Inpatient Hospital Services (e.g., Hospital Stay)$1000.00 Copay per Stay after deductible
Outpatient Surgery Physician/Surgical ServicesNo Charge after deductible
Urgent Care Centers or Facilities$80.00 Copay after deductible

Pharmacy

BenefitIn-network
Generic Drugs$30.00 Copay after deductible
Non-Preferred Brand Drugs$200.00 Copay after deductible
Off Label Prescription Drugs$200.00 Copay after deductible
Preferred Brand Drugs$100.00 Copay after deductible
Specialty Drugs$200.00 Copay after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services$1000.00 Copay per Stay after deductible
Mental/Behavioral Health Outpatient Services$50.00 Copay after deductible

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNo Charge after deductible
Accidental Dental$50.00 Copay after deductible
Acupuncture$50.00 Copay after deductible
Allergy Testing$55.00 Copay after deductible
Bariatric Surgery$1000.00 Copay after deductible
Basic Dental Care - ChildNo charge
Bone Marrow Transplants for Treatment of Breast Cancer$1000.00 Copay after deductible
Cardiac Rehabilitation$80.00 Copay after deductible
ChemotherapyNo Charge after deductible
Childbirth ClassesNo charge
Chiropractic Care$50.00 Copay after deductible
Clinical Trials$1000.00 Copay after deductible
Congenital Anomaly, including Cleft Lip/Palate$1000.00 Copay after deductible
Contraceptive ServicesNo charge
Delivery and All Inpatient Services for Maternity Care$1000.00 Copay after deductible
Dental Check-Up for ChildrenNo charge
Diabetes Care Management$50.00 Copay after deductible
Diabetes Education$80.00 Copay after deductible
DialysisNo Charge after deductible
Durable Medical Equipment20.00% Coinsurance after deductible
Early Intervention ServicesNo Charge after deductible
Emergency Transportation/AmbulanceNo Charge after deductible
Eye Glasses for Children50.00%
Fitness Club ReimbursementNo charge
Gender Affirming Care$1000.00 Copay after deductible
Habilitation Services$80.00 Copay after deductible
Hearing Aids20.00% Coinsurance after deductible
Home Health Care ServicesNo Charge after deductible
Hormone Replacement Therapy (HRT)$50.00 Copay after deductible
Hospice ServicesNo Charge after deductible
Human Leukocyte Antigen Testing$55.00 Copay after deductible
Hypodermic Syringes or Needles$100.00 Copay after deductible
Imaging (CT/PET Scans, MRIs)$500.00 Copay after deductible
Infertility TreatmentNo Charge after deductible
Infusion TherapyNo Charge after deductible
Inherited Metabolic Disorders - PKUNo Charge after deductible
Inpatient Physician and Surgical ServicesNo Charge after deductible
Inpatient Rehabilitation Services$1000.00 Copay after deductible
Laboratory Outpatient and Professional Services$55.00 Copay after deductible
Low Protein FoodsNo Charge after deductible
Major Dental Care - Child50.00%
Minor Dental Care - Child20.00% Coinsurance after deductible
Nutrition/FormulasNo Charge after deductible
Nutritional Counseling$50.00 Copay after deductible
Orthodontia - Child50.00%
Other Practitioner Office Visit (Nurse, Physician Assistant)$50.00 Copay after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)$500.00 Copay after deductible
Outpatient Rehabilitation Services$80.00 Copay after deductible
Prenatal and Postnatal CareNo charge
Prosthetic Devices20.00% Coinsurance after deductible
RadiationNo Charge after deductible
Reconstructive Surgery$1000.00 Copay after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$80.00 Copay after deductible
Rehabilitative Speech Therapy$80.00 Copay after deductible
Retail Health Clinics$50.00 Copay after deductible
Routine Eye Exam (Adult)$80.00 Copay after deductible
Routine Eye Exam for Children$80.00 Copay after deductible
Routine Foot Care$80.00 Copay after deductible
Skilled Nursing Facility$1000.00 Copay per Stay after deductible
Substance Abuse Disorder Inpatient Services$1000.00 Copay per Stay after deductible
Substance Abuse Disorder Outpatient Services$50.00 Copay after deductible
Transplant$1000.00 Copay after deductible
Treatment for Temporomandibular Joint Disorders$500.00 Copay after deductible
Weight Loss ProgramsNo charge
Well Baby Visits and CareNo charge
Wigs20.00% Coinsurance after deductible
X-rays and Diagnostic Imaging$120.00 Copay after deductible

Service area

This plan covers 1 geographic area.

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