Bronze Elite + PCP Saver Plus

Oscar Health Plan, Inc. · 2027 plan year

Expanded BronzeHSA eligible
Ind. medical deductible
$0
Rx deductible (separate)
$7,500
Family deductible
$0
Ind. OOP max
$12,000
Family OOP max
$24,000

This plan sets a separate deductible for prescription drugs. The medical deductible shown does not cover prescriptions; they have their own.

Compare with other Expanded Bronze plans in SC

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

More Oscar Health Plan, Inc. plans in SC

Monthly premiums by age

Rating Area 46 — the lowest-priced of the 6 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$368$368
21$482$482
30$547$552
40$615$622
50$860$869
60$1,307$1,320
64 and over$1,445$1,459

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$125.00

Hospital

BenefitIn-network
Emergency Room Services$2,500.00
Inpatient Hospital Services (e.g., Hospital Stay)$3000.00 Copay per Day
Outpatient Surgery Physician/Surgical Services$350.00
Urgent Care Centers or Facilities$40.00

Pharmacy

BenefitIn-network
Generic Drugs$4.00
Non-Preferred Brand Drugs50.00% Coinsurance after deductible
Preferred Brand Drugs$125.00 Copay after deductible
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services$3000.00 Copay per Day
Mental/Behavioral Health Outpatient Services$125.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental50.00%
AcupunctureNot covered
Allergy Testing$125.00
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Chemotherapy50.00%
Chiropractic CareNot covered
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care$3,000.00
Dental Check-Up for ChildrenNot covered
Diabetes EducationNo charge
Dialysis50.00%
Durable Medical Equipment50.00%
Emergency Transportation/Ambulance50.00%
Eye Glasses for ChildrenNo charge
Habilitation Services$125.00
Hearing AidsNot covered
Home Health Care Services50.00%
Hospice Services50.00%
Imaging (CT/PET Scans, MRIs)$750.00
Infertility TreatmentNot covered
Infusion Therapy50.00%
Inpatient Physician and Surgical Services$350.00
Laboratory Outpatient and Professional Services$65.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutritional CounselingNo charge
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$50.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)$1,500.00
Outpatient Rehabilitation Services$125.00
Prenatal and Postnatal CareNo charge
Private-Duty NursingNot covered
Prosthetic Devices50.00%
Radiation50.00%
Reconstructive Surgery$3,000.00
Rehabilitative Occupational and Rehabilitative Physical Therapy$125.00
Rehabilitative Speech Therapy$125.00
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility$3000.00 Copay per Day
Substance Abuse Disorder Inpatient Services$3000.00 Copay per Day
Substance Abuse Disorder Outpatient Services$125.00
Transplant$3,000.00
Treatment for Temporomandibular Joint DisordersNot covered
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging$150.00

Plan rules

Service area

This plan covers 6 geographic areas.

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