Molina Healthcare Wisconsin

 

Plan Overviews

Molina Healthcare, a FORTUNE 500, multi-state health care organization, arranges for the delivery of health care services and offers health information management solutions to nearly five million individuals and families who receive their care through Medicaid, Medicare and other government-funded programs in fifteen states.

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What are the benefits of Bronze plans?
High deductible plans will work best for consumers that have little to no regular doctor’s appointments or medications. They will have the lowest premium rates as well as the highest out of pocket costs. This would be best suited for someone in good health that only goes to the doctor for their annual well being visits and or tests.

The Bronze plan is a good deal if you are healthy and rarely use medical services. You may receive assistance from the government that will pay for or reduce your premium. Preventive care is free but co-pays, co-insurance and deductible for most other services will be more expensive.

Molina Bronze Plan(HMO):

 Deductible $6,650
 Out of Pocket Max:  $7,150
 Primary Care Provider Visits:  $35
 Deductible  $6,650
 Out of Pocked Max  $7,150
 Primary Care Provider Visits  $35
 Specialist Office Visits –  $80 after deductible
 Mental Illness and Substance Abuse Treatment  $35
 ER Visit  $350 after deductible
Urgent Care  $75 after deductible
  In Patient Hospital Care  40% after deductible
 Out Patient Surgery  40% after deductible
 Out Patient X-Rays and Diagnostic Imaging  $80 after deductible
 Out Patient imaging(CT/PET/MRIs)  40% after deductible
 Outpatient Prescription Drugs(preferred pharmacy)  $33/$65(after deductible)/50%(after deductible)/50% after deductible/No charge after deductible
The Silver plans are the best value for most individuals or families. Silver plans also get the most financial assistance in the form of Cost Sharing Reductions. This means you save more! These plans offer low premiums and the lowest out-of-pocket costs.

 Molina Silver 100 Plan(HMO):

Deductible $0
Out of Pocked Max $1,250
Primary Care Provider Visits $0 Copay
Specialist Office Visits $10 Copay
Mental Illness and Substance Abuse Treatment $0 Copay
ER Visit $150 copay
Urgent Care $15 copay
In Patient Hospital Care 10% coinsurance
Out Patient Surgery 20% coinsurance
Out Patient X-Rays and Diagnostic Imaging  $10 coinsurance
Out Patient imaging(CT/PET/MRIs)  10% coinsurance
 Outpatient Prescription Drugs(preferred pharmacy)  $2/$15/20% copay/20% coinsurance

 Molina Silver 150 Plan(HMO):

Deductible $500
Out of Pocked Max $2,250
Primary Care Provider Visits $10
Specialist Office Visits $30
Mental Illness and Substance Abuse Treatment $20
ER Visit $205
Urgent Care – $30 copay
In Patient Hospital Care 20% coinsurance
Out Patient Surgery 20% coinsurance
Out Patient X-Rays and Diagnostic Imaging  $30 coinsurance
 Out Patient imaging(CT/PET/MRIs)  20% coinsurance
 HSA Eligible   No
 Outpatient Prescription Drugs(preferred pharmacy)  $5/$30/30% copay/20%coinsurance
 Outpatient Prescription Drugs(Non Preferred Pharmacy)  Not Covered

 Molina Silver 200 Plan(HMO):

Deductible $2,275
Out of Pocked Max $5,700
Primary Care Provider Visits $20
Specialist Office Visits $55
Mental Illness and Substance Abuse Treatment $20
ER Visit $400
Urgent Care $75
In Patient Hospital Care 30% coinsurance
Out Patient Surgery 30% coinsurance
Out Patient X-Rays and Diagnostic Imaging  $55 coinsurance
 Out Patient imaging(CT/PET/MRIs)  30% coinsurance
 Outpatient Prescription Drugs(preferred pharmacy)  $10/$55/40%/40%
 Outpatient Prescription Drugs(Non Preferred Pharmacy)  Not Covered

Molina Silver 250 Plan(HMO):

Deductible $2,400
Out of Pocked Max $7,150
Primary Care Provider Visits $20
Specialist Office Visits $55
Mental Illness and Substance Abuse Treatment $20 copay
ER Visit $400 Copay
Urgent Care $75 Copay
In Patient Hospital Care 30% coinsurance
Out Patient Surgery 30% coinsurance
Out Patient X-Rays and Diagnostic Imaging  $55 coinsurance
 Out Patient imaging(CT/PET/MRIs)  $30% coinsurance
 Outpatient Prescription Drugs(preferred pharmacy)  $10/$55/40%/40%
 Outpatient Prescription Drugs(Non Preferred Pharmacy)  Not Covered

Molina Gold Plan(HMO):

Deductible $1,025
Out of Pocked Max $7,150
Primary Care Provider Visits $15 copay
Specialist Office Visits $35
Mental Illness and Substance Abuse Treatment $15 Copay
ER Visit $300 Copay
Urgent Care $60 Copay
In Patient Hospital Care 20% coinsurance
Out Patient Surgery 20% coinsurance
Out Patient X-Rays and Diagnostic Imaging  $35 Copay
 Out Patient imaging(CT/PET/MRIs)  20% Coinsurance
 Outpatient Prescription Drugs(preferred pharmacy)  $15/$50/30% coinsurance/30% coinsurance
 Outpatient Prescription Drugs(Non Preferred Pharmacy)  Not Covered

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Plan Brochures
Molina Bronze Molina Silver 100 Molina Silver 150 Molina Silver 200 Molina Silver 250 Molina Gold Plan
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Phone: (312) 726-6565
Email: [email protected]

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