Blue Cross Blue Shield Blue Advantage Silver 2800 (North Carolina)

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Company Blue Cross and Blue Shield of North Carolina
Plan Year 2014
State North Carolina
Metal Tier Silver
Plan Type PPO
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Cost Sharing Benefits (In Network)

These details are for the standard Silver plan. For reduced Cost Sharing versions scroll down below

Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.

Deductible (Individual) $2,800
Deductible (Family) $5,600
Coinsurance 30%
Out of Pocket Maximum (Individual) $6,350
Out of Pocket Maximum (Family) $12,700

Doctors Visits

Primary Care Visit $30
Specialist Visit $60
In Patient Hospital Services 30% Coinsurance after deductible
Emergency Room Services $150

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 30% coinsurance
Laboratory Outpatient and Professional Services 30% coinsurance
X-ray and Diagnostic Imaging 30% coinsurance

Other

Mental / Behavioral Health $50 copay
Rehabilitative Speech Therapy $60 copay
Rehabilitative Occupational & Physical Therapy $60 copay
Outpatient Facility 30% coinsurance
Outpatient Surgery 30% coinsurance

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx $70 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

73% Cost Sharing Benefits

Households with incomes between 200% to 250% of FPL qualify for the following cost sharing benefits for this silver plan. To understand how cost sharing reductions work and how they work for you see our article about Obamacare Cost Sharing Reduction Discounts

Deductibles and Cost Sharing

Deductible (Individual) $2,700.00
Deductible (Family) $5,400.00
Out of Pocket Maximum (Individual) $4,900.00
Out of Pocket Maximum (Family) $9,800.00
Primary Care Physician $25
Specialists $50
Emergency Room $150
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible
Prescription Drugs In Network Out of Network
Generic Rx $10 Copay after deductible
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx $70 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

87% Cost Sharing Benefits

Households with incomes between 150% to 200% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $1,000.00
Deductible (Family) $2,000.00
Out of Pocket Maximum (Individual) $2,000.00
Out of Pocket Maximum (Family) $4,000.00
Services In Network Out of Network
Primary Care Physician $5
Specialists $10
Emergency Room $100
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible
Prescription Drugs In Network Out of Network
Generic Rx $10 Copay after deductible
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx $70 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

94% Cost Sharing Benefits

Households with incomes between 138% to 150% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $500.00
Deductible (Family) $1,000.0
Out of Pocket Maximum (Individual) $700.00
Out of Pocket Maximum (Family) $1,400.00
Services In Network Out of Network
Primary Care Physician $5
Specialists $10
Emergency Room $100
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible
Prescription Drugs In Network Out of Network
Generic Rx $10 Copay after deductible
Preferred Brand Rx $50 Copay after deductible
Non Preferred Brand Rx $70 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

Other Plans

Other plans that are available in the state.

Plan Name
Blue Advantage 500 (broad network)
Blue Advantage 1000 (broad network)
Blue Advantage 2800 (broad network)
Blue Advantage 3500 (broad network)
Blue Advantage S 5000 (broad network)
Blue Advantage G 0 (broad network)
Blue Advantage 2700 (broad network, HSA eligible)
Blue Advantage 5500 (broad network, HSA eligible)
Blue Advantage S 0 (broad network)
Blue Advantage B 5000 (broad network)
Blue Advantage Catastrophic (broad network)
Blue Advantage 3000 (broad network)
Blue Value 500 (limited network)
Blue Value 1000 (limited network)
Blue Value 2800 (limited network)
Blue Value 3500 (limited network)
Blue Value S 5000 (limited network)
Blue Value G 0 (limited network)
Blue Value 2700 (limited network, HSA eligible)
Blue Value 5500 (limited network, HSA eligible)
Blue Value S 0 (limited network)
Blue Value B 5000 (limited network)
Blue Value Catastrophic (limited network)
Blue Value 3000 (limited network)
Blue Value 500 (limited network)
Blue Value 1000 (limited network)
Blue Value 2800 (limited network)
Blue Value 3500 (limited network)
Blue Value S 5000 (limited network)
Blue Value G 0 (limited network)
Blue Value 2700 (limited network, HSA eligible)
Blue Value 5500 (limited network, HSA eligible)
Blue Value S 0 (limited network)
Blue Value B 5000 (limited network)
Blue Value Catastrophic (limited network)
Blue Value 3000 (limited network)
Blue Select 1000 (tiered network)
Blue Select 3500 (tiered network)
Blue Select 1000 (tiered network)
Blue Select 3500 (tiered network)
Blue Select 5500 (tiered network)
Blue Select 5500 (tiered network)
Blue Local 500 (local network with Carolinas HealthCare System)
Blue Local 1000 (local network with Carolinas HealthCare System)
Blue Local 3500 (local network with Carolinas HealthCare System)
Blue Local 3000 (local network with Carolinas HealthCare System)
Blue Local 5500 (local network with Carolinas HealthCare System, HSA eligible)
Blue Local B 5000 (local network with Carolinas HealthCare System)

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