QUARTZ EASY COMPARE BRONZE (VISION) LIMITED COST SHARE SELECT

Quartz Health Plan MN Corporation · 2027 plan year

Expanded BronzeHSA eligible

Ind. deductible: $8,000
Family deductible: $16,000
Ind. OOP max: $10,200
Family OOP max: $20,400

Other cost-sharing reduction variants for this plan:

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

More Quartz Health Plan MN Corporation plans in MN

QUARTZ SELECT SILVER (VISION) $8,500 DED QUARTZ SELECT BRONZE (VISION) $8,500 HSA QUARTZ SELECT CATASTROPHIC (VISION) $12,000 DED QUARTZ SELECT GOLD MAINTENANCE (VISION) $700 DED QUARTZ EASY COMPARE GOLD FLAT RX COPAYS (VISION) SELECT

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	$75.00

Specialist

Benefit	In-network
Specialist Visit	$160.00

Hospital

Benefit	In-network
Emergency Room Services	50.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	50.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	50.00% Coinsurance after deductible
Urgent Care Centers or Facilities	$120.00

Pharmacy

Benefit	In-network
Generic Drugs	$25.00
Non-Preferred Brand Drugs	50.00% Coinsurance after deductible
Preferred Brand Drugs	50.00% Coinsurance after deductible
Specialty Drugs	50.00% Coinsurance after deductible

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	$75.00

Other

Benefit	In-network
Abortion for Which Public Funding is Prohibited	50.00% Coinsurance after deductible
Accidental Dental	50.00% Coinsurance after deductible
Acupuncture	50.00% Coinsurance after deductible
Allergy Testing	50.00% Coinsurance after deductible
Chemotherapy	50.00% Coinsurance after deductible
Chiropractic Care	$75.00
Clinical Trials	50.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care	50.00% Coinsurance after deductible
Diabetes Education	50.00% Coinsurance after deductible
Dialysis	50.00% Coinsurance after deductible
Durable Medical Equipment	50.00%
Emergency Transportation/Ambulance	50.00% Coinsurance after deductible
Eye Glasses for Children	50.00%
Gender Affirming Care	50.00% Coinsurance after deductible
Habilitation Services	$80.00
Hearing Aids	50.00%
Home Health Care Services	50.00% Coinsurance after deductible
Hospice Services	50.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	50.00% Coinsurance after deductible
Infusion Therapy	50.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	50.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	50.00% Coinsurance after deductible
Nutritional Counseling	$75.00
Other Practitioner Office Visit (Nurse, Physician Assistant)	$75.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	50.00% Coinsurance after deductible
Outpatient Rehabilitation Services	$80.00
PANDAS/PANS	50.00% Coinsurance after deductible
Prenatal and Postnatal Care	No charge
Prosthetic Devices	50.00%
Radiation	50.00% Coinsurance after deductible
Reconstructive Surgery	50.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	$80.00
Rehabilitative Speech Therapy	$80.00
Routine Eye Exam (Adult)	$75.00
Routine Eye Exam for Children	$75.00
Routine Foot Care	50.00% Coinsurance after deductible
Skilled Nursing Facility	50.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	50.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	$75.00
Transplant	50.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	50.00% Coinsurance after deductible
Virtual Visit	$75.00
Well Baby Visits and Care	No charge
Wigs	50.00% Coinsurance after deductible
X-rays and Diagnostic Imaging	50.00% Coinsurance after deductible

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