Blue Cross Blue Shield BlueCross Silver S16E TN

Plan Information
Company BlueCross BlueShield of Tennessee
State TN
Metal Tier Silver
Plan Type PPO

Cost Sharing Benefits

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.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $3,500 $7,000
Deductible (Family) $7,000 $14,000
Coinsurance $0 50%
Out of Pocket Maximum (Individual) $3,500 $10,500
Out of Pocket Maximum (Family) $7,000 $21,000
Services In Network Out of Network
Primary Care Visit No Charge 50% coinsurance
Specialist Visit No Charge 50% coinsurance
In Patient Hospital Services No Charge 50% coinsurance
Emergency Room Services No Charge $0
Mental / Behavioral Health $0 50% coinsurance
Imaging (CT/PET Scans, MRIs) $0 50% coinsurance
Rehabilitative Speech Therapy $0 50% coinsurance
Rehabilitative Occupational & Physical Therapy $0 50% coinsurance
Preventative Care $0 50% coinsurance
Laboratory Outpatient and Professional Services $0 50% coinsurance
X-ray and Diagnostic Imaging $0 50% coinsurance
Outpatient Facility $0 50% coinsurance
Outpatient Surgery $0 50% coinsurance
Prescription Drugs In Network Out of Network
Generic Rx No Charge
Preferred Brand Rx No Charge
Non Preferred Brand Rx No Charge
Specialty Drugs No Charge

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 In Network Out of Network
Deductible (Individual) $2,950.00
Deductible (Family) $5,900.00
Out of Pocket Maximum (Individual) $2,950.00
Out of Pocket Maximum (Family) $5,900.00
Services In Network Out of Network
Primary Care Physician No Charge
Specialists No Charge
Emergency Room No Charge
Inpatient Facility No Charge
Inpatient Physician No Charge
Prescription Drugs In Network Out of Network
Generic Rx No Charge
Preferred Brand Rx No Charge
Non Preferred Brand Rx No Charge
Specialty Drugs No Charge

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) $1,150.00
Deductible (Family) $2,300.00
Out of Pocket Maximum (Individual) $1,150.00
Out of Pocket Maximum (Family) $2,300.00
Services In Network Out of Network
Primary Care Physician No Charge
Specialists No Charge
Emergency Room No Charge
Inpatient Facility No Charge
Inpatient Physician No Charge
Prescription Drugs In Network Out of Network
Generic Rx No Charge
Preferred Brand Rx No Charge
Non Preferred Brand Rx No Charge
Specialty Drugs No Charge

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) $500.00
Out of Pocket Maximum (Family) $1,000.00
Services In Network Out of Network
Primary Care Physician No Charge
Specialists No Charge
Emergency Room No Charge
Inpatient Facility No Charge
Inpatient Physician No Charge
Prescription Drugs In Network Out of Network
Generic Rx No Charge
Preferred Brand Rx No Charge
Non Preferred Brand Rx No Charge
Specialty Drugs No Charge

Other Plans

Other plans that are available in the state.

Plan Name
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