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Blue - Blue Cross Blue Shield Basic
Montana, 2017
Plan Type
PPO
Metal Tier
Bronze
Out of Pocket Maximum
$7,150
Deductible
$6,100
Emergency Room Care: $1000 Copay before deductible + 30% Coinsurance after deductible
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) | $6,100 |
|---|---|
| Deductible (Family) | $12,200 |
| Coinsurance | Not applicable |
| Out of Pocket Maximum (Individual) | $7,150 |
| Out of Pocket Maximum (Family) | $14,300 |
Doctor Visits
| Primary Care Visit | 30% Coinsurance after deductible |
|---|---|
| Specialist Visit | 30% Coinsurance after deductible |
| Inpatient Facility | $750 Copay per stay before deductible + 30% Coinsurance after deductible |
| Inpatient Physician | 30% Coinsurance after deductible |
| Emergency Room Services | $1000 Copay before deductible + 30% Coinsurance after deductible |
Tests and Imaging
| Imaging (CT/PET Scans, MRIs) | $500 Copay before deductible + 30% Coinsurance after deductible |
|---|---|
| Laboratory Outpatient and Professional Services | 30% Coinsurance after deductible |
| X-Ray and Diagnostic Imaging | 30% Coinsurance after deductible |
Health Management Programs
| Asthma | Available |
|---|---|
| Depression | Available |
| Diabetes | Available |
| Heart Disease | Available |
| High Blood Pressure / High Cholesterol | Available |
| Lower Back Pain | Available |
| Pain Management | Not available |
| Pregnancy | Available |
| Weight Loss | Not available |
Other
| Mental / Behavioral Health Inpatient | $750 Copay per stay before deductible + 30% Coinsurance after deductible |
|---|---|
| Mental / Behavioral Health Outpatient | No charge |
| Rehabilitative Speech Therapy | 30% Coinsurance after deductible |
| Rehabilitative Occupational & Physical Therapy | 30% Coinsurance after deductible |
| Outpatient Facility | $400 Copay before deductible + 30% Coinsurance after deductible |
| Outpatient Surgery | $400 Copay before deductible + 30% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | 20% Coinsurance after deductible |
|---|---|
| Preferred Brand Rx | 30% Coinsurance after deductible |
| Non Preferred Brand Rx | 40% Coinsurance after deductible |
| Specialty Drugs | 50% Coinsurance after deductible |
Other Plans in Montana
| Plan | Deductible | Coinsurance | Out of Pocket |
|---|---|---|---|
| Plan Blue Preferred Bronze PPO | Deductible $6,500 | Coinsurance Not applicable | Out of Pocket $6,500 |
| Plan Blue Cross Blue Shield Premier | Deductible $1,650 | Coinsurance Not applicable | Out of Pocket $3,350 |
| Plan Blue Preferred Silver PPO | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $4,500 |
| Plan Blue Preferred Bronze PPO | Deductible $6,350 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Focus Silver POS | Deductible $2,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Cross Blue Shield Basic | Deductible $6,100 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Preferred Gold PPO | Deductible $1,400 | Coinsurance Not applicable | Out of Pocket $3,350 |
| Plan Blue Preferred Bronze PPO | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan Blue Preferred Security PPO | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Cross Blue Shield Premier | Deductible $1,650 | Coinsurance Not applicable | Out of Pocket $3,350 |
| Plan Blue Focus Bronze POS | Deductible $6,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Cross Blue Shield Premier | Deductible $1,650 | Coinsurance Not applicable | Out of Pocket $3,350 |
| Plan Blue Preferred Silver PPO | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $4,500 |
| Plan Blue Preferred Security PPO | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Preferred Bronze PPO | Deductible $6,350 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Preferred Bronze PPO | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan Blue Preferred Security PPO | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Focus Silver POS | Deductible $3,850 | Coinsurance Not applicable | Out of Pocket $6,850 |
| Plan Blue Cross Blue Shield Basic | Deductible $6,100 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Preferred Bronze PPO | Deductible $6,350 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Preferred Silver PPO | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $4,500 |
| Plan Blue Preferred Bronze PPO | Deductible $6,500 | Coinsurance Not applicable | Out of Pocket $6,500 |
| Plan Blue Cross Blue Shield Solution | Deductible $3,350 | Coinsurance Not applicable | Out of Pocket $5,600 |
| Plan Blue Preferred Silver PPO | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $4,500 |
| Plan Blue Preferred Bronze PPO | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan Blue Preferred Gold PPO | Deductible $1,400 | Coinsurance Not applicable | Out of Pocket $3,350 |
| Plan Blue Preferred Silver PPO | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $6,600 |
| Plan Blue Preferred Silver PPO | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $6,600 |
| Plan Blue Focus Bronze POS | Deductible $6,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Cross Blue Shield Solution | Deductible $3,350 | Coinsurance Not applicable | Out of Pocket $5,600 |
| Plan Blue Focus Silver POS | Deductible $3,850 | Coinsurance Not applicable | Out of Pocket $6,850 |
| Plan Blue Cross Blue Shield Solution | Deductible $3,350 | Coinsurance Not applicable | Out of Pocket $5,600 |
| Plan Blue Cross Blue Shield Premier | Deductible $1,650 | Coinsurance Not applicable | Out of Pocket $3,350 |
| Plan Blue Preferred Security PPO | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Preferred Bronze PPO | Deductible $6,500 | Coinsurance Not applicable | Out of Pocket $6,500 |
| Plan Blue Preferred Silver PPO | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $6,600 |
| Plan Blue Focus Silver POS | Deductible $2,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Cross Blue Shield Solution | Deductible $3,350 | Coinsurance Not applicable | Out of Pocket $5,600 |
| Plan Blue Focus Gold POS | Deductible $500 | Coinsurance Not applicable | Out of Pocket $5,250 |
| Plan Blue Cross Blue Shield Basic | Deductible $6,100 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Preferred Bronze PPO | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan Blue Preferred Silver PPO | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $6,600 |
| Plan Blue Preferred Gold PPO | Deductible $1,400 | Coinsurance Not applicable | Out of Pocket $3,350 |
| Plan Blue Preferred Bronze PPO | Deductible $6,500 | Coinsurance Not applicable | Out of Pocket $6,500 |
| Plan Blue Focus Gold POS | Deductible $500 | Coinsurance Not applicable | Out of Pocket $5,250 |
| Plan Blue Preferred Bronze PPO | Deductible $6,350 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Preferred Gold PPO | Deductible $1,400 | Coinsurance Not applicable | Out of Pocket $3,350 |