WPS BRIDGE65 PPO – Wisconsin Health Insurance Plan
A detailed comparison of the WPS BRIDGE65 PPO health insurance plan as offered in Wisconsin is listed below for both Network and Non-Network coverage. This is a review of the coverage for this specific WPS plan. However, GoHealthInsurance offers a large variety of health insurance options to fit your needs. If you wish, get a new WPS health insurance quote for Wisconsin now or view all of our WPS health insurance quotes.
| Network | Non-Network | |
|---|---|---|
| Copay | $25 | N/A |
| OfficeVisit | $25 copay then 100% (including chiropractors) | Deductible & Coinsurance (including chiropractors) |
| Deductible true | Individual/Children: $2,000/$6,000 | Individual/Children: $4,000/$12,000 |
| Coinsurance | 0% | 20% |
| Coinsurance Limit | Individual/Children: $5,000/$15,000 | Individual/Children: $5,000/$15,000 |
| Out-of-Pocket Maximum | $2 million | $2 million |
| Lifetime Maximum | ||
| Prescription Drugs | Prescription Drugs (including insulin, disposable diabetic supplies, oral contraceptives, contraceptives path, NuvaRing, and transplant drugs; prior approval required for certain drugs): No Drug Coverage - First tier is generic drugs: $15 generic; second | Prescription Drugs (including insulin, disposable diabetic supplies, oral contraceptives, contraceptives path, NuvaRing, and transplant drugs; prior approval required for certain drugs): Preferred reimbursement level - First tier is generic drugs: Preferr |
| Emergency Room | Emergency Room Facility Fees: Preferred Deductible & Coinsurance; Emergency Room Care (including physician charges & miscellaneous expenses): Preferred Deductible & Coinsurance; Ambulance (prior approval required for non-emergency transport): Preferred De | Emergency Room Facility Fees: Preferred Deductible & Coinsurance; Emergency Room Care (including physician charges & miscellaneous expenses): Preferred Deductible & Coinsurance; Ambulance (prior approval required for non-emergency transport): Preferred De |
| Adult Preventative Care | A & B Preventive Services (Preventive services rated A or B by the U.S. Preventive Services Task Force are covered at 100%, including recommended immunizations, preventive care for infants, children, and adolescents, and additional preventive care and scr | A & B Preventive Services (Preventive services rated A or B by the U.S. Preventive Services Task Force are covered at 100%, including recommended immunizations, preventive care for infants, children, and adolescents, and additional preventive care and scr |
| Child Preventative Care | A & B Preventive Services (Preventive services rated A or B by the U.S. Preventive Services Task Force are covered at 100%, including recommended immunizations, preventive care for infants, children, and adolescents, and additional preventive care and scr | A & B Preventive Services (Preventive services rated A or B by the U.S. Preventive Services Task Force are covered at 100%, including recommended immunizations, preventive care for infants, children, and adolescents, and additional preventive care and scr |
| Lab / X-Ray | Coinsurance, or if no copay, Deductible & Coinsurance | Deductible & Coinsurance |
| Maternity | Not covered (except those covered as preventive) | Not covered (except those covered as preventive) |
| Physical Therapy | Rehabilitative Therapy (occupational/physical/speech/respiratory/massage; up to 40 sessions per calendar year): Deductible & Coinsurance; Radiation and Chemotherapy Services: Deductible & Coinsurance; Cardiac Rehabilitation Services: Deductible & Coinsura | Rehabilitative Therapy (occupational/physical/speech/respiratory/massage; up to 40 sessions per calendar year): Deductible & Coinsurance; Radiation and Chemotherapy Services: Deductible & Coinsurance; Cardiac Rehabilitation Services: Deductible & Coinsura |
| Home Health Care | Home Health Services (up to 40 visits per year): Deductible & Coinsurance; Home IV Therapy and Supplies (prior approval required): Deductible & Coinsurance | Home Health Services (up to 40 visits per year): Deductible & Coinsurance; Home IV Therapy and Supplies (prior approval required): Deductible & Coinsurance |
| Mental Health | ||
| Hospital Care | Room and Board, Miscellaneous Hospital Expenses, and Intensive Care Unit (prior approval required): Deductible & Coinsurance; Outpatient Facility Fees: Deductible & Coinsurance; Outpatient Radiology, Pathology, and Lab Services: Coinsurance, or if no copa | Room and Board, Miscellaneous Hospital Expenses, and Intensive Care Unit (prior approval required): Deductible & Coinsurance; Outpatient Facility Fees: Deductible & Coinsurance; Outpatient Radiology, Pathology, and Lab Services: Deductible & Coinsurance; |
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