Healthfirst Bronze Leaf Plan - Benefits

Each Leaf Plan offers the same great health benefits, including checkups, maternity care, emergency services, hospitalization, prescription drugs, lab work, and more. The difference is that your monthly premium payment and other costs will vary based on the plan you choose. 

See below for more information on cost, covered benefits, and prescription drug coverage for the Healthfirst Bronze Leaf Plan. For help understanding terms like deductible and coinsurance, please visit the Glossary.

Cost (Individual)

Deductible $3,000
Coinsurance 50%
Maximum Out-Of-Pocket Cost
(MOOP)
$6,350

Cost (Family)

Deductible $6,000
Coinsurance 50%
Maximum Out-Of-Pocket Cost
(MOOP)
$12,700

 

Covered Benefits (Individual and Family)

Preventive Care No deductible or cost sharing applies to preventive care visits or services as defined in section 2713 of the ACA
Primary Care Physician 50% coinsurance
Specialist 50% coinsurance

PT/OT/ST: Rehabilitative & Habilitative Services

50% coinsurance
Urgent Care 50% coinsurance
Emergency Room 50% coinsurance
Ambulance 50% coinsurance
Surgeon, Anesthesiologist 50% coinsurance
Outpatient facility 50% coinsurance
Inpatient Facility /
Skilled Nursing Facility
50% coinsurance

 

Prescription Drugs (Individual and Family)

Generic $10 copay*
Brand Name (formulary) $35 copay*
Brand Name (not in formulary) $70 copay*

*Your prescription drug benefit only applies after your deductible is met.

The benefit information provided above is a brief summary, not a comprehensive description of benefits.

For more information please click here.