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Blue - Blue Value 7150 (limited network)
North Carolina, 2017
Plan Type
POS
Metal Tier
Bronze
Out of Pocket Maximum
$7,150
Deductible
$7,150
Emergency Room Care: 0% 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) | $7,150 |
|---|---|
| Deductible (Family) | $14,300 |
| Coinsurance | Not applicable |
| Out of Pocket Maximum (Individual) | $7,150 |
| Out of Pocket Maximum (Family) | $14,300 |
Doctor Visits
| Primary Care Visit | 0% Coinsurance after deductible |
|---|---|
| Specialist Visit | 0% Coinsurance after deductible |
| Inpatient Facility | $0 Copay per stay + 0% Coinsurance after deductible |
| Inpatient Physician | 0% Coinsurance after deductible |
| Emergency Room Services | 0% Coinsurance after deductible |
Tests and Imaging
| Imaging (CT/PET Scans, MRIs) | 0% Coinsurance after deductible |
|---|---|
| Laboratory Outpatient and Professional Services | 0% Coinsurance after deductible |
| X-Ray and Diagnostic Imaging | 0% 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 | Not available |
| Pregnancy | Available |
| Weight Loss | Available |
Other
| Mental / Behavioral Health Inpatient | 0% Coinsurance after deductible |
|---|---|
| Mental / Behavioral Health Outpatient | 0% Coinsurance after deductible |
| Rehabilitative Speech Therapy | 0% Coinsurance after deductible |
| Rehabilitative Occupational & Physical Therapy | 0% Coinsurance after deductible |
| Outpatient Facility | 0% Coinsurance after deductible |
| Outpatient Surgery | 0% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | 0% Coinsurance after deductible |
|---|---|
| Preferred Brand Rx | 0% Coinsurance after deductible |
| Non Preferred Brand Rx | 0% Coinsurance after deductible |
| Specialty Drugs | 0% Coinsurance after deductible |
Other Plans in North Carolina
| Plan | Deductible | Coinsurance | Out of Pocket |
|---|---|---|---|
| Plan Blue Advantage 5500 (broad network, HSA eligible) | Deductible $5,500 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan Blue Local 7150 (local network with Duke Medicine and WakeMed) | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Local 3500 (local network with Duke Medicine and WakeMed) | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Local 7150 (local network with Carolinas HealthCare System) | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Value Catastrophic (limited network) | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Value 3500 (limited network) | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Advantage 5000 (broad network) | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Value 5000 (limited network) | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Value Catastrophic (limited network) | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Value 7150 (limited network) | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Select 1500 (tiered network) | Deductible $1,500 | Coinsurance Not applicable | Out of Pocket $6,000 |
| Plan Blue Local 1500 (local network with Duke Medicine and WakeMed) | Deductible $1,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Local 5000 (local network with Duke Medicine and WakeMed) | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Advantage Catastrophic (broad network) | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Local 3500 (local network with Carolinas HealthCare System) | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Local 5500 (local network with Duke Medicine and WakeMed, HSA eligible) | Deductible $5,500 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan Blue Value 1500 (limited network) | Deductible $1,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Local 5500 (local network with Carolinas HealthCare System, HSA eligible) | Deductible $5,500 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan Blue Value 3500 (limited network) | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Value 5500 (limited network, HSA eligible) | Deductible $5,500 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan Blue Value 5500 (limited network, HSA eligible) | Deductible $5,500 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan Blue Select 1500 (tiered network) | Deductible $1,500 | Coinsurance Not applicable | Out of Pocket $6,000 |
| Plan Blue Value 1500 (limited network) | Deductible $1,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Select 5000 (tiered network) | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Advantage 1500 (broad network) | Deductible $1,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Select 5000 (tiered network) | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Value 5000 (limited network) | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Advantage 3500 (broad network) | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Local 5000 (local network with Carolinas HealthCare System) | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Advantage 7150 (broad network) | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan Blue Local 1500 (local network with Carolinas HealthCare System) | Deductible $1,500 | Coinsurance Not applicable | Out of Pocket $7,150 |