Select Health Value Bronze $6900 Medical Deductible HSA Eligible

SelectHealth, Inc. · 2027 plan year

Expanded BronzeHSA eligible
Ind. deductible
$6,900
Family deductible
$13,800
Ind. OOP max
$12,000
Family OOP max
$24,000

Compare with other Expanded Bronze plans in CO

Side by side: deductibles, out-of-pocket limits and copays.

More SelectHealth, Inc. plans in CO

Monthly premiums by age

Rating Area 4 — the lowest-priced of the 7 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$294$294
21$385$385
30$436$436
40$491$526
50$687$755
60$1,044$1,200
64 and over$1,154$1,327

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$50.00

Specialist

BenefitIn-network
Specialist Visit$90.00 Copay after deductible

Hospital

BenefitIn-network
Emergency Room Services40.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)40.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services40.00% Coinsurance after deductible
Urgent Care Centers or Facilities$65.00

Pharmacy

BenefitIn-network
Generic Drugs$30.00
Medical Service Drugs50.00% Coinsurance after deductible
Non-Preferred Brand Drugs50.00% Coinsurance after deductible
Non-Preferred Generic Drugs$40.00
Preferred Brand Drugs$55.00 Copay after deductible
Preventive DrugsNo charge
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Intensive Outpatient for Mental/Behavioral Health40.00% Coinsurance after deductible
Intensive Outpatient for Substance Use Disorder40.00% Coinsurance after deductible
Mental Health Wellness VisitNo charge
Mental/Behavioral Health Inpatient Services40.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$90.00 Copay after deductible
Mental/Behavioral Health Prenatal CareNo Charge after deductible
Office Visit - Mental/Behavioral Health$90.00 Copay after deductible
Office Visit - Substance Use Disorder$90.00 Copay after deductible
Partial Hospitalization for Mental/Behavioral Health40.00% Coinsurance after deductible
Partial Hospitalization for Substance Use Disorder40.00% Coinsurance after deductible
Postpartum Mental/Behavioral Health$50.00
Postpartum Substance Use Disorder$50.00
Residential Day Treatment for Mental/Behavioral Health40.00% Coinsurance after deductible
Residential Day Treatment for Substance Use Disorder40.00% Coinsurance after deductible
Substance Use Disorder Prenatal CareNo Charge after deductible
Telehealth Mental/Behavioral Health$50.00
Telehealth Substance Use Disorder$50.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNo charge
Acupuncture$50.00
Allergy Testing$90.00 Copay after deductible
Applied Behavior Analysis Based TherapiesNo Charge after deductible
Autism Spectrum Disorders - Assessment and Evaluation Services$90.00 Copay after deductible
Bariatric Surgery40.00% Coinsurance after deductible
Chemotherapy50.00% Coinsurance after deductible
Chiropractic Care$50.00
Delivery and All Inpatient Services for Maternity Care40.00% Coinsurance after deductible
Diabetes Education$90.00 Copay after deductible
Diabetic Supplies40.00% Coinsurance after deductible
Dialysis$90.00 Copay after deductible
Durable Medical Equipment40.00% Coinsurance after deductible
Emergency Transportation/Ambulance40.00% Coinsurance after deductible
Eye Glasses for Children$90.00 Copay after deductible
Gender Affirming Care40.00% Coinsurance after deductible
Habilitation Services$90.00 Copay after deductible
Hearing Aids40.00% Coinsurance after deductible
Home Health Care Services$90.00 Copay after deductible
Hospice Services$90.00 Copay after deductible
Imaging (CT/PET Scans, MRIs)40.00% Coinsurance after deductible
Infertility Treatment40.00% Coinsurance after deductible
Infusion Therapy40.00% Coinsurance after deductible
Inpatient Physician and Surgical Services40.00% Coinsurance after deductible
Inpatient Rehabilitation40.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services$50.00
Nutritional Counseling$90.00 Copay after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)$50.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)40.00% Coinsurance after deductible
Outpatient Rehabilitation Services$90.00 Copay after deductible
Prenatal and Postnatal CareNo Charge after deductible
Private-Duty Nursing$90.00 Copay after deductible
Prosthetic Devices40.00% Coinsurance after deductible
Prosthetics: Legs and Arms20.00%
Prosthetics: Recreational40.00% Coinsurance after deductible
Radiation40.00% Coinsurance after deductible
Reconstructive Surgery40.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$90.00 Copay after deductible
Rehabilitative Occupational Therapy$90.00 Copay after deductible
Rehabilitative Physical Therapy$90.00 Copay after deductible
Rehabilitative Speech Therapy$90.00 Copay after deductible
Routine Eye Exam for ChildrenNo charge
Skilled Nursing Facility40.00% Coinsurance after deductible
Standalone Laboratory$50.00
Substance Abuse Disorder Inpatient Services40.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$90.00 Copay after deductible
Telehealth PCPNo charge
Telehealth Specialist$90.00 Copay after deductible
Transplant40.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders40.00% Coinsurance after deductible
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging10.00% Coinsurance after deductible

Service area

This plan covers 17 geographic areas.

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