2020 Covered California Bronze 60 HSA Rx Benefits
The Covered California Bronze 60 HSA plan does not include a separate Rx deductible. Rather, the medical deductible applies to all Rx regardless of tier. So, in order for coverage to kick in, the plan deductible ($4,500 for individuals, $9,000 for families) must first be met. Once the plan deductible is met, the member will have a copay of 40% of the cost of the prescription
|Individual||$4,500 deductible for medical and drugs|
|Family||$9,000 deductible for medical and drugs|
|Tier 1 (generic) Rx Copay||40% after deductible|
|Tier 2 (preferred brand) Rx Copay||40% after deductible|
|Tier 3 (non-preferred brand) Rx Copay||40% after deductible|
|Tier 4 (specialty) Rx Copay||40% after deductible|
It is comforting to know that if you take multiple medications, expensive medications or you experience a year in which you need a lot of prescriptions the most you will pay for anything (prescription drug costs included) in a year, is the out-of-pocket maximum which is $6,500 for an individual or $13,000 for a family on the Bronze plan.
You’re prescribed a Tier 1(generic) drug by your Doctor that costs $100. You will pay the full $100 since the drug cost is less than the deductible.
You’re prescribed a Tier 4 (specialty) drug that costs $5,000. You will pay $4,500 of the cost to cover the deductible and 40% of the remaining balance. Your total cost would be $4,700.
Later that that year you’re prescribed another Tier 4 (specialty) drug by your Doctor. The cost of this drug is also $5,000. Since you had previously met your deductible, this time you will only pay 40% of the total cost or $2,000. However, the Bronze 60 HSA plan has a Maximum Out-of-Pocket of $6,500. Therefore your total cost for the second prescription will be $1,800.
Not sure how Obamacare affects your health care plans in California? Learn how the ACA works in California, including benefits, costs and enrollment.
Covered California is the Golden State’s official health exchange marketplace where individuals, families and small businesses can find high-quality, low-cost California government health insurance.
Learn about Obamacare income guidelines in California using our income limits chart, and see if you’re eligible for government assistance.
Learn about the Covered California website. Find easy online enrollment. Set up your account, log in, buy insurance and more on the California health marketplace website.