2021 Health Plan Options

Bronze Plan

Together with CCHP offers plan options across four different levels to our members. Plan benefits described below are for in-network services only.

Click on the buttons below to see benefits for each plan level. After November 1, get a quote and enroll with our Online Quote Tool. You can also call our Sales Support team directly for help at 844-708-3837.

Catastrophic Bronze Silver Gold Silver Choice (Off-Exchange only)

With an high deductible health plan (HDHP), you have the ability to combine your health insurance plan with a Health Savings Account (HSA) that provides for tax-free payment or reimbursement of eligible medical expenses to help lower your medical costs.


	Bronze	Bronze HDHP
Individual medical and prescription deductible	$7,000	$7,000
Individual medical and prescription maximum out-of-pocket¹	$8,550	$7,000
Family medical and prescription maximum deductible	$14,000	$14,000
Family medical and prescription out-of-pocket maximum¹	$17,100	$14,000

Primary care office visit	$60 copay	0% after deductible
Speciality / specialist office visit	$120 copay	0% after deductible
Inpatient and outpatient services	50% after deductible	0% after deductible
Outpatient lab services	50% after deductible	0% after deductible
Urgent care	50% after deductible	0% after deductible
Emergency room	50% after deductible	0% after deductible

Prescription Drugs²
Tier 1: Generic	$20 copay	0% after deductible
Tier 2: Preferred brand	50% after deductible	0% after deductible
Tier 3: Non-preferred brand	50% after deductible	0% after deductible
Tier 4: Specialty prescriptions³	50% after deductible	0% after deductible
Tier 5: ACA preventive prescriptions	$0	$0
Tier 6: Select generics, including select Insulin	$0	$0

Health management programs
CCHP on Call Nurseline

¹The out-of-pocket maximum is the sum of the deductible amount, prescription drug deductible amount (if applicable), copayment amount and coinsurance percentage of covered expenses, as shown in your Evidence of Coverage.
²For a list of covered preventive prescriptions, please review our 2020 Prescription Medication List (available November 1st)
³Many specialty medications are paid according to medical plan benefits, not prescription drug benefits.

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Medicaid

Children's Community Health Plan

PO Box 56099
Madison, WI 53705
1-800-482-8010

Together with CCHP

Children's Community Health Plan

PO Box 1997, MS 6280
Milwaukee, WI 53201
1-844-201-4672