Highmark - Health Savings Blue EPO 1700

Delaware, 2017

  • Plan Type

    EPO

  • Metal Tier

    Gold

  • Out of Pocket Maximum

    $3,250

  • Deductible

    $1,700

Enroll Now
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Call (855) 866-5590 to speak with a licensed agent about a new health plan.

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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) $1,700
Deductible (Family) $3,400
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $3,250
Out of Pocket Maximum (Family) $6,500

Doctor Visits

Primary Care Visit 10% Coinsurance after deductible
Specialist Visit 10% Coinsurance after deductible
Inpatient Facility 10% Coinsurance after deductible
Inpatient Physician 10% Coinsurance after deductible
Emergency Room Services 10% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 10% Coinsurance after deductible
Laboratory Outpatient and Professional Services 10% Coinsurance after deductible
X-Ray and Diagnostic Imaging 10% Coinsurance after deductible

Health Management Programs

Asthma Available
Depression Available
Diabetes Available
Heart Disease Available
High Blood Pressure / High Cholesterol Available
Lower Back Pain Not available
Pain Management Available
Pregnancy Available
Weight Loss Available

Other

Mental / Behavioral Health Inpatient 10% Coinsurance after deductible
Mental / Behavioral Health Outpatient 10% Coinsurance after deductible
Rehabilitative Speech Therapy 10% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 10% Coinsurance after deductible
Outpatient Facility 10% Coinsurance after deductible
Outpatient Surgery 10% Coinsurance after deductible

Prescription Drugs

Generic Rx 10% Coinsurance after deductible
Preferred Brand Rx 10% Coinsurance after deductible
Non Preferred Brand Rx 10% Coinsurance after deductible
Specialty Drugs 10% Coinsurance after deductible

Other Plans in Delaware

Plan Shared Cost Blue EPO 1000 Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,000
Plan Shared Cost Blue EPO 4200 Deductible $4,200 Coinsurance Not applicable Out of Pocket $7,150
Plan Health Savings Embedded Blue EPO 6500 Deductible $6,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Major Events Blue EPO 7150 Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan Total Health Flex Blue EPO 3000 Deductible $3,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Shared Cost Blue EPO 6800 Deductible $6,800 Coinsurance Not applicable Out of Pocket $7,150
Plan Health Savings Embedded Blue EPO 3250 Deductible $3,250 Coinsurance Not applicable Out of Pocket $6,500
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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) $1,700
Deductible (Family) $3,400
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $3,250
Out of Pocket Maximum (Family) $6,500

Doctor Visits

Primary Care Visit 10% Coinsurance after deductible
Specialist Visit 10% Coinsurance after deductible
Inpatient Facility 10% Coinsurance after deductible
Inpatient Physician 10% Coinsurance after deductible
Emergency Room Services 10% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 10% Coinsurance after deductible
Laboratory Outpatient and Professional Services 10% Coinsurance after deductible
X-Ray and Diagnostic Imaging 10% Coinsurance after deductible

Health Management Programs

Asthma Available
Depression Available
Diabetes Available
Heart Disease Available
High Blood Pressure / High Cholesterol Available
Lower Back Pain Not available
Pain Management Available
Pregnancy Available
Weight Loss Available

Other

Mental / Behavioral Health Inpatient 10% Coinsurance after deductible
Mental / Behavioral Health Outpatient 10% Coinsurance after deductible
Rehabilitative Speech Therapy 10% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 10% Coinsurance after deductible
Outpatient Facility 10% Coinsurance after deductible
Outpatient Surgery 10% Coinsurance after deductible

Prescription Drugs

Generic Rx 10% Coinsurance after deductible
Preferred Brand Rx 10% Coinsurance after deductible
Non Preferred Brand Rx 10% Coinsurance after deductible
Specialty Drugs 10% Coinsurance after deductible

Other Plans in Delaware

Plan Shared Cost Blue EPO 1000 Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,000
Plan Shared Cost Blue EPO 4200 Deductible $4,200 Coinsurance Not applicable Out of Pocket $7,150
Plan Health Savings Embedded Blue EPO 6500 Deductible $6,500 Coinsurance Not applicable Out of Pocket $6,500
Plan Major Events Blue EPO 7150 Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan Total Health Flex Blue EPO 3000 Deductible $3,000 Coinsurance Not applicable Out of Pocket $7,150
Plan Shared Cost Blue EPO 6800 Deductible $6,800 Coinsurance Not applicable Out of Pocket $7,150
Plan Health Savings Embedded Blue EPO 3250 Deductible $3,250 Coinsurance Not applicable Out of Pocket $6,500