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Blue - Blue Value Gold
Alabama, 2017
Plan Type
PPO
Metal Tier
Gold
Out of Pocket Maximum
$6,000
Deductible
$750
Emergency Room Care: Data Not Available
Cost Sharing Benefits (In Network)
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) | $750 |
|---|---|
| Deductible (Family) | $1,500 |
| Coinsurance | Not applicable |
| Out of Pocket Maximum (Individual) | $6,000 |
| Out of Pocket Maximum (Family) | $12,000 |
Doctor Visits
| Primary Care Visit | Data Not Available |
|---|---|
| Specialist Visit | Data Not Available |
| Inpatient Facility | $225 Copay per day |
| Inpatient Physician | 0% Coinsurance after deductible |
| Emergency Room Services | Data Not Available |
Tests and Imaging
| Imaging (CT/PET Scans, MRIs) | Data Not Available |
|---|---|
| Laboratory Outpatient and Professional Services | No charge |
| X-Ray and Diagnostic Imaging | Data Not Available |
Health Management Programs
| Asthma | Available |
|---|---|
| Depression | Not available |
| Diabetes | Available |
| Heart Disease | Available |
| High Blood Pressure / High Cholesterol | Not available |
| Lower Back Pain | Not available |
| Pain Management | Not available |
| Pregnancy | Available |
| Weight Loss | Not available |
Other
| Mental / Behavioral Health Inpatient | No charge |
|---|---|
| Mental / Behavioral Health Outpatient | Data Not Available |
| Rehabilitative Speech Therapy | 20% Coinsurance after deductible |
| Rehabilitative Occupational & Physical Therapy | 20% Coinsurance after deductible |
| Outpatient Facility | Data Not Available |
| Outpatient Surgery | 0% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | Data Not Available |
|---|---|
| Preferred Brand Rx | Data Not Available |
| Non Preferred Brand Rx | Data Not Available |
| Specialty Drugs |
Other Plans in Alabama
| Plan | Deductible | Coinsurance | Out of Pocket |
|---|---|---|---|
| Plan Blue Cross Select Gold, a Multi-State Plan | Deductible $850 | Coinsurance Not applicable | Out of Pocket $6,000 |
| Plan Blue HSA Bronze | Deductible $6,450 | Coinsurance Not applicable | Out of Pocket $6,450 |
| Plan Blue Cross Select Silver, a Multi-State Plan | Deductible $2,800 | Coinsurance Not applicable | Out of Pocket $6,850 |
| Plan Blue Saver Bronze | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Protect | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Value Silver | Deductible $2,600 | Coinsurance Not applicable | Out of Pocket $6,850 |