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
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 |