Ohio health plan · 2025

UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) · 33931OH0070004

UnitedHealthcare of Ohio, Inc. offers this marketplace health insurance plan (Plan ID 33931OH0070004) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.

Metal level: Expanded Bronze Plan type: HMO CSR: Standard Bronze Off Exchange Plan Issuer: UnitedHealthcare of Ohio, Inc.
Telehealth Data pending HSA eligible No Dental Adult/Child Vision Adult/Child
Pay / Manage Plan View issuer site

Issuer actuarial value: 64.14%. Expect to pay roughly 35.86% of covered costs out of pocket, based on issuer reporting.

2025 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 02 Dec 2025 06:13 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.

Monthly premium

$265 – $1221

Before subsidies

Estimate after subsidies

Deductible

N/A

N/A

See deductible details

Max out-of-pocket

$9,200

$18400 per group

Review MOOP rules

Office visits

Primary care $50.00
Specialist $150.00
HSA Not eligible

Drug tiers

Generic $15.00
Preferred brand 40.00% Coinsurance after deductible

View formulary tiers

$366 / mo before subsidies

≈ $4392 per year before tax credits.

Start with this unsubsidized premium, then apply marketplace tax credits to see your final monthly payment.

  • Ideal for shoppers comparing Bronze vs. Silver budgets.
  • Update your Marketplace application to apply premium tax credits.

$1150 / mo before subsidies

≈ $13798 per year before tax credits.

Pre-subsidy rate for a couple with one dependent. Switch to Silver CSR plans if you qualify to reduce these numbers.

  • Compares well against PPO vs HMO networks when planning for childcare and telehealth needs.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$1392 / mo before subsidies

≈ $16710 per year before tax credits.

Pairs with cost-sharing reductions (CSR) when you select a Silver tier and qualify based on income.

  • Use this estimate before adding childcare, dental, or vision extras.
  • CSR Silver variants can lower deductibles dramatically for eligible incomes.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$885 / mo before subsidies

≈ $10619 per year before tax credits.

Shows the combined pre-subsidy rate for two adults. Add dependents or subsidies in your application to refine it.

  • Great for households deciding between PPO and HMO networks.
  • Telehealth and HSA perks (when offered) apply to both members.
Issuer profile See benefits

Preventive Care/Screening/Immunization

No Charge

Emergency Room Services

$2,000.00

Durable Medical Equipment

50.00%

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Enrollment guidance

Stay on top of 2025 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Ohio). Submit changes before the deadline to avoid a coverage gap.

  • Enroll by Dec 15 for Jan 1 starts.
  • Finalize plan switches before the window closes.

Special Enrollment Periods

You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).

  • Report the event within 60 days.
  • Keep documentation handy for Healthcare.gov or your state exchange.

CSR & subsidy reminders

Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.

  • Enter accurate income to maximize Advanced Premium Tax Credits.
  • Standard Bronze Off Exchange Plan plans like this one keep deductibles and copays lower if you qualify.

Thinking about switching?

Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.

  • Match provider networks so ongoing care isn’t disrupted.
  • Confirm prescriptions stay on-formulary or budget for tier changes.

Top covered benefits

How this plan handles key care scenarios

Preventive Care/Screening/Immunization

No Charge

Emergency Room Services

$2,000.00

Durable Medical Equipment

50.00%

Premium snapshot

Plan identifiers & filings

Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.

Plan ID 33931OH0070004
Coverage year 2025
State Ohio
Issuer UnitedHealthcare of Ohio, Inc.
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 33931OH0070004-00
Available variants

Standard Off Exchange Plan · 33931OH0070004-00

Standard On Exchange Plan · 33931OH0070004-01

Open to Indians below 300% FPL · 33931OH0070004-02

Open to Indians above 300% FPL · 33931OH0070004-03
Last plan update Fri, 13 Sep 2024 00:00 GMT
Last HealthPorta import Tue, 02 Dec 2025 06:13 GMT

Network stats

Provider access snapshot

Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).

All providers in Ohio 21
PCPs in Ohio 2
Telehealth support Data pending
Nationwide providers 24
21 doctors statewide 2 PCPs

Provider network(s)

Providers Ohio All US states
All 21 24
PCP 2 3
Allergy N/A N/A
OB/GYN N/A N/A
Dentists N/A N/A

Drug coverage overview

3,742 drugs tracked

Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.

Tier Covered drugs
NON-PREFERRED-BRAND 1,436
PREFERRED-GENERIC 1,398
ZERO-COST-SHARE-PREVENTIVE 482
SPECIALTY 426
Prior authorization Drugs
Required 671
Not Required 3,071
Step therapy Drugs
Required 52
Not Required 3,690
Quantity limits Drugs
Has Limit 1,739
No Limit 2,003

Customer highlights

What stands out for members

  • Issuer: UnitedHealthcare of Ohio, Inc. · Plan ID 33931OH0070004 · 2025 filing.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 33931OH0070004-00 (Standard Off Exchange Plan) currently displayed.
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Benefits

Covered services & limitations

Everyday care

Office visits, preventive care, labs, imaging, and home health.

Chiropractic Care

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

Limit: 12.0 Visit(s) per Benefit Period

nan

Exclusions: nan

Diabetes Education

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

nan

Exclusions: nan

Home Health Care Services

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

Limit: 100.0 Visit(s) per Year

The 100 visit/year limit is not applicable to home infusion therapy or private duty nursing rendered in the home setting.

Exclusions: nan

Laboratory Outpatient and Professional Services

$35.00
Tier 1 in-network $35.00
Out-of-network 100.00%

Cost sharing may differ based on the location where services are provided. Please refer to the Certificate of Coverage for more information.

Exclusions: nan

Other Practitioner Office Visit (Nurse, Physician Assistant)

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

nan

Exclusions: nan

Preventive Care/Screening/Immunization

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

nan

Exclusions: nan

Primary Care Visit to Treat an Injury or Illness

$50.00
Tier 1 in-network $50.00
Out-of-network 100.00%

Cost sharing for Virtual Primary Care matches in-person office visit.

Exclusions: nan

Rehabilitative Occupational and Rehabilitative Physical Therapy

$150.00
Tier 1 in-network $150.00
Out-of-network 100.00%

Limit: 40.0 Visit(s) per Year

Limited to 20 visits per year for Occupational Therapy and 20 visits per year for Physical Therapy.

Exclusions: nan

Rehabilitative Speech Therapy

$150.00
Tier 1 in-network $150.00
Out-of-network 100.00%

Limit: 20.0 Visit(s) per Year

Limited to 20 visits per year for Speech Therapy

Exclusions: nan

Specialist Visit

$150.00
Tier 1 in-network $150.00
Out-of-network 100.00%

nan

Exclusions: nan

Urgent Care Centers or Facilities

$100.00
Tier 1 in-network $100.00
Out-of-network 100.00%

$0 Virtual Urgent Care visits are available through vendor. See SBC for additional cost share details for in-person urgent care visits.

Exclusions: nan

X-rays and Diagnostic Imaging

$100.00
Tier 1 in-network $100.00
Out-of-network 100.00%

Cost sharing may differ based on the location where services are provided. Please refer to the Certificate of Coverage for more information.

Exclusions: nan

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Chemotherapy

$750.00
Tier 1 in-network $750.00
Out-of-network 100.00%

nan

Exclusions: nan

Delivery and All Inpatient Services for Maternity Care

$3,000.00
Tier 1 in-network $3,000.00
Out-of-network 100.00%

Childbirth/delivery professional services follow inpatient physician/surgeon fees.

Exclusions: nan

Dialysis

$750.00
Tier 1 in-network $750.00
Out-of-network 100.00%

nan

Exclusions: nan

Durable Medical Equipment

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

nan

Exclusions: nan

Emergency Room Services

$2,000.00
Tier 1 in-network $2,000.00
Out-of-network $2,000.00

nan

Exclusions: nan

Emergency Transportation/Ambulance

$2,000.00
Tier 1 in-network $2,000.00
Out-of-network $2,000.00

nan

Exclusions: nan

Hospice Services

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

nan

Exclusions: nan

Inpatient Hospital Services (e.g., Hospital Stay)

$3000.00 Copay per Day
Tier 1 in-network $3000.00 Copay per Day
Out-of-network 100.00%

nan

Exclusions: nan

Inpatient Physician and Surgical Services

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

nan

Exclusions: nan

Mental/Behavioral Health Inpatient Services

$3000.00 Copay per Day
Tier 1 in-network $3000.00 Copay per Day
Out-of-network 100.00%

nan

Exclusions: nan

Mental/Behavioral Health Outpatient Services

$100.00
Tier 1 in-network $100.00
Out-of-network 100.00%

Cost share applies to office visits, please see SBC for Mental Health Outpatient Services.

Exclusions: nan

Outpatient Facility Fee (e.g., Ambulatory Surgery Center)

$450.00
Tier 1 in-network $450.00
Out-of-network 100.00%

nan

Exclusions: nan

Outpatient Rehabilitation Services

$150.00
Tier 1 in-network $150.00
Out-of-network 100.00%

Limit: 60.0 Visit(s) per Year

Limited to 20 visits per year for Speech Therapy, 20 visits per year for Occupational Therapy, 20 visits per year for Physical Therapy, 36 visits per year for Cardiac rehabilitation Therapy, and 20 visits per year for Pulmonary rehabilitation therapy.

Exclusions: nan

Outpatient Surgery Physician/Surgical Services

$450.00
Tier 1 in-network $450.00
Out-of-network 100.00%

nan

Exclusions: nan

Radiation

$150.00
Tier 1 in-network $150.00
Out-of-network 100.00%

nan

Exclusions: nan

Skilled Nursing Facility

$3000.00 Copay per Day
Tier 1 in-network $3000.00 Copay per Day
Out-of-network 100.00%

Limit: 90.0 Days per Year

Limit will be 90 days per benefit period for Skilled Nursing Facility. Limits will be 60 days per benefit period for inpatient physical medicine and rehabilitation.

Exclusions: nan

Substance Abuse Disorder Inpatient Services

$3000.00 Copay per Day
Tier 1 in-network $3000.00 Copay per Day
Out-of-network 100.00%

nan

Exclusions: nan

Substance Abuse Disorder Outpatient Services

$100.00
Tier 1 in-network $100.00
Out-of-network 100.00%

nan

Exclusions: nan

Transplant

$3,000.00
Tier 1 in-network $3,000.00
Out-of-network 100.00%

nan

Exclusions: nan

Pregnancy & family

Maternity, newborn, pediatric dental and vision extras.

Basic Dental Care - Child

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

Benefit limitations may apply to individual services.

Exclusions: nan

Hearing Aids

Coverage details pending

Cochlear implants are covered as durable medical equipment.

Exclusions: nan

Major Dental Care - Child

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

Benefit limitations may apply to individual services.

Exclusions: nan

Prenatal and Postnatal Care

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

nan

Exclusions: nan

Routine Eye Exam for Children

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Limit: 1.0 Visit(s) per Year

nan

Exclusions: nan

Well Baby Visits and Care

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

nan

Exclusions: nan

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

$15.00
Tier 1 in-network $15.00
Out-of-network 100.00%

Members can obtain a 1 month supply through network pharmacies or home delivery. Members also have the option to receive a 3 month supply through network pharmacy or home delivery. Other quantity limits may apply. Check the plan's Summary of Benefits or Prescription Drug List for more information.

Exclusions: nan

Non-Preferred Brand Drugs

45.00% Coinsurance after deductible
Tier 1 in-network 45.00% Coinsurance after deductible
Out-of-network 100.00%

Members can obtain a 1 month supply through network pharmacies or home delivery. Members also have the option to receive a 3 month supply through network pharmacy or home delivery. Other quantity limits may apply. Check the plan's Summary of Benefits or Prescription Drug List for more information.

Exclusions: nan

Preferred Brand Drugs

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 100.00%

Members can obtain a 1 month supply through network pharmacies or home delivery. Members also have the option to receive a 3 month supply through network pharmacy or home delivery. Other quantity limits may apply. Check the plan's Summary of Benefits or Prescription Drug List for more information.

Exclusions: nan

Specialty Drugs

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Specialty medications are limited to a 1-month supply. Other quantity limits may apply. Check the plan's Summary of Benefits or Prescription Drug List for more information.

Exclusions: nan

Wellness & extras

Vision, dental, therapies, prosthetics, weight management.

Accidental Dental

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

nan

Exclusions: nan

Basic Dental Care - Adult

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

Limit: 1000.0 Dollars per Year

1,000 annual benefit maximum includes all Dental Services (Routine, Basic and Major) for Adults; Excluded from In-Network Deductible and Out-of-Pocket Limit

Exclusions: nan

Dental Check-Up for Children

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Limit: 1.0 Exam(s) per 6 Months

nan

Exclusions: nan

Infusion Therapy

$150.00
Tier 1 in-network $150.00
Out-of-network 100.00%

nan

Exclusions: nan

Major Dental Care - Adult

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

Limit: 1000.0 Dollars per Year

1,000 annual benefit maximum includes all Dental Services (Routine, Basic and Major) for Adults; Excluded from In-Network Deductible and Out-of-Pocket Limit

Exclusions: nan

Nutritional Counseling

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

Medical or behavioral/mental health related nutritional education services that are provided as part of treatment for a disease are covered

Exclusions: nan

Orthodontia - Adult

Coverage details pending

nan

Exclusions: nan

Orthodontia - Child

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

Coverage is for medically necessary orthodontia only.

Exclusions: nan

Prosthetic Devices

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

nan

Exclusions: nan

Routine Dental Services (Adult)

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Limit: 2.0 Visit(s) per Year

1,000 annual benefit maximum includes all Dental Services (Routine, Basic and Major) for Adults; Excluded from In-Network Deductible and Out-of-Pocket Limit

Exclusions: nan

Weight Loss Programs

Coverage details pending

nan

Exclusions: nan

Additional benefits

Other plan-specific services and limitations.

Abortion for Which Public Funding is Prohibited

Coverage details pending

nan

Exclusions: nan

Acupuncture

Coverage details pending

nan

Exclusions: nan

Allergy Testing

$150.00
Tier 1 in-network $150.00
Out-of-network 100.00%

nan

Exclusions: nan

Bariatric Surgery

Coverage details pending

nan

Exclusions: nan

Cosmetic Surgery

Coverage details pending

nan

Exclusions: nan

Eye Glasses - Adult

$25.00
Tier 1 in-network $25.00
Out-of-network 100.00%

Limit: 1.0 Item(s) per Year

Excluded from In-Network Out-of-Pocket Limit

Exclusions: nan

Eye Glasses for Children

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

Limit: 1.0 Item(s) per Year

nan

Exclusions: nan

Gender Affirming Care

$450.00
Tier 1 in-network $450.00
Out-of-network 100.00%

Covered when medically necessary.

Exclusions: nan

Habilitation Services

$150.00
Tier 1 in-network $150.00
Out-of-network 100.00%

Limit: 60.0 Visit(s) per Year

Limited to 20 visits per year for Speech Therapy, 20 visits per year for Occupational Therapy, and 20 visits per year for Physical Therapy. Visit limits do not apply for therapies for covered persons with a primary diagnosis of Autism Spectrum Disorder.

Exclusions: nan

Imaging (CT/PET Scans, MRIs)

$200.00
Tier 1 in-network $200.00
Out-of-network 100.00%

Cost sharing may differ based on the location where services are provided. Please refer to the Certificate of Coverage for more information.

Exclusions: nan

Infertility Treatment

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

Plan covers Diagnosis and treatment of cause of infertility. Benefits are available for covered services such as office visits, laboratory tests, and radiological studies to diagnose the cause of infertility. Benefits are also provided for the necessary treatment of the condition unless the treatment is identified as non-covered (see exclusions). Depending upon where the covered service is provided, benefits will be the same as those stated under each health care service category.

Exclusions: Health care services and related expenses for infertility treatments, including assisted reproductive technology, in vitro fertilization, in vivo fertilization, or any other medically-aided insemination procedure, regardless of the reason for the treatment, except when performed for the diagnosis, treatment and correction of the underlying causes of infertility.

Long-Term/Custodial Nursing Home Care

Coverage details pending

nan

Exclusions: nan

Private-Duty Nursing

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

Limit: 90.0 Visit(s) per Year

Private Duty Nursing Services are Covered Services only when provided through the Home Health Care Services benefit.

Exclusions: nan

Reconstructive Surgery

$450.00
Tier 1 in-network $450.00
Out-of-network 100.00%

nan

Exclusions: nan

Routine Eye Exam (Adult)

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Limit: 1.0 Visit(s) per Year

Benefit also includes 1 pair of eyeglasses or contact lenses every 12 months. Eyeglass lenses have a $25 copay and frames are covered up to $150. Formulary contact lenses are covered in lieu of glasses with a $25 copay.

Exclusions: nan

Routine Foot Care

Coverage details pending

Covered when done for the prevention of complications associated with metabolic, neurologic, or peripheral vascular disease

Exclusions: nan

Treatment for Temporomandibular Joint Disorders

50.00%
Tier 1 in-network 50.00%
Out-of-network 100.00%

nan

Exclusions: nan

Variant attributes

UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) · Variant 33931OH0070004-00

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2025

CSR Variation Type

Standard Bronze Off Exchange Plan

HIOS Product ID

33931OH007

Metal Level

Expanded Bronze

Plan ID (Standard Component ID with Variant)

33931OH0070004-00

Plan Marketing Name

UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals)

Plan Variant Marketing Name

UHC Bronze-X Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals)

Issuer & service area

Issuer-provided metadata for this variant.

Issuer Actuarial Value

64.14%

Issuer ID

33931

Issuer Marketplace Marketing Name

UnitedHealthcare

Market Coverage

Individual

Multiple In Network Tiers

No

National Network

No

Network ID

OHN011

Out of Country Coverage

No

Out of Service Area Coverage

Yes

Out of Service Area Coverage Description

Plan covers eligible expenses provided by a Network Physician or other provider or facility within the Network Area. The Network Area may include select Network providers located in a neighboring state. The plan also covers emergency health care services received outside the service area.

Service Area ID

OHS011

State Code

OH

URL for Summary of Benefits & Coverage

Open link

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

Begin Primary Care Deductible Coinsurance After Number Of Copays

0

Drug EHB Deductible, In Network (Tier 1), Default Coinsurance

0.00%

Inpatient Copayment Maximum Days

3

Medical Drug Deductibles Integrated

No

Medical Drug Maximum Out of Pocket Integrated

Yes

Medical EHB Deductible, In Network (Tier 1), Default Coinsurance

50.00%

SBC Scenario, Having a Baby, Coinsurance

$0

SBC Scenario, Having a Baby, Copayment

$3,800

SBC Scenario, Having a Baby, Deductible

$0

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$700

SBC Scenario, Having Diabetes, Deductible

$0

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$20

SBC Scenario, Treatment of a Simple Fracture, Copayment

$2,700

SBC Scenario, Treatment of a Simple Fracture, Deductible

$0

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group

per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person

per person not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual

Not Applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group

$18400 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person

$9200 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual

$9,200

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group

per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person

per person not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual

Not Applicable

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

OHF028

Formulary URL

Open link

Plan Brochure

Open link

SBC Scenario, Having a Baby, Limit

$60

SBC Scenario, Having Diabetes, Limit

$0

SBC Scenario, Treatment of a Simple Fracture, Limit

$0

URL for Enrollment Payment

Open link

Additional attributes

Issuer-provided metadata for this variant.

Begin Primary Care Cost-Sharing After Number Of Visits

0

Child-Only Offering

Allows Adult and Child-Only

Composite Rating Offered

No

Drug EHB Deductible, Combined In/Out of Network, Family Per Group

per group not applicable

Drug EHB Deductible, Combined In/Out of Network, Family Per Person

per person not applicable

Drug EHB Deductible, Combined In/Out of Network, Individual

Not Applicable

Drug EHB Deductible, In Network (Tier 1), Family Per Group

$9000 per group

Drug EHB Deductible, In Network (Tier 1), Family Per Person

$4500 per person

Drug EHB Deductible, In Network (Tier 1), Individual

$4,500

Drug EHB Deductible, Out of Network, Family Per Group

per group not applicable

Drug EHB Deductible, Out of Network, Family Per Person

per person not applicable

Drug EHB Deductible, Out of Network, Individual

Not Applicable

Dental Only Plan

No

Design Type

Not Applicable

EHB Percent of Total Premium

0.97150004

First Tier Utilization

100%

Import Date

2024-09-13 20:01:37

Limited Cost Sharing Plan Variation - Estimated Advanced Payment

$0.00

HSA Eligible

No

New/Existing Plan

New

Notice Required for Pregnancy

No

Is a Referral Required for Specialist?

No

Medical EHB Deductible, Combined In/Out of Network, Family Per Group

per group not applicable

Medical EHB Deductible, Combined In/Out of Network, Family Per Person

per person not applicable

Medical EHB Deductible, Combined In/Out of Network, Individual

Not Applicable

Medical EHB Deductible, In Network (Tier 1), Family Per Group

$0 per group

Medical EHB Deductible, In Network (Tier 1), Family Per Person

$0 per person

Medical EHB Deductible, In Network (Tier 1), Individual

$0

Medical EHB Deductible, Out of Network, Family Per Group

per group not applicable

Medical EHB Deductible, Out of Network, Family Per Person

per person not applicable

Medical EHB Deductible, Out of Network, Individual

Not Applicable

Plan Effective Date

2025-01-01

Plan Level Exclusions

Some exclusions may apply. See the applicable Certificate of Coverage for details.

Plan Type

HMO

QHP/Non QHP

Both

Source Name

SERFF

Plan ID

33931OH0070004

Unique Plan Design

Yes

Wellness Program Offered

No

Copay & coinsurance

Pharmacy cost sharing by tier

Drug tier Pharmacy type Copay amount Copay option Coinsurance rate Coinsurance option Mail order

Questions & answers

Frequently asked questions

How do I choose the right ACA plan in Ohio?

UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) (33931OH0070004) is a Expanded Bronze HMO from UnitedHealthcare of Ohio, Inc. in Ohio for the 2025 coverage year.

Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.

Does UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) support telehealth or virtual urgent care?

The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.

Is UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) HSA-eligible and does it include dental or vision coverage?

It is not marked as HSA-eligible, so confirm with the issuer before relying on tax-advantaged savings.

Dental add-ons: Adult, Child.

Vision add-ons: Adult, Child.

Does UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) support mail-order prescriptions?

Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.

Is there out-of-country coverage for UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals)?

No, out-of-country services are not covered for this plan.

Does UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) cover care outside the service area?

Yes, you have limited out-of-area coverage. See the plan documents for referral and prior authorization rules. Details: Plan covers eligible expenses provided by a Network Physician or other provider or facility within the Network Area. The Network Area may include select Network providers located in a neighboring state. The plan also covers emergency health care services received outside the service area.

How do I enroll in or manage payments for UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals)?

Use the issuer portal https://sso.uhc.com/ext/sp/ACS.saml2 to pay premiums or start enrollment, then return to HealthPorta for benefit comparisons.

Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
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