Highmark - my Connect Blue EPO 6500B, a Community Blue Flex Plan

Pennsylvania, 2017

  • Plan Type

    EPO

  • Metal Tier

    Bronze

  • Out of Pocket Maximum

    $7,150

  • Deductible

    $6,500

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) $6,500
Deductible (Family) $13,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,150
Out of Pocket Maximum (Family) $14,300

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility $1500 Copay per stay
Inpatient Physician 30% Coinsurance after deductible
Emergency Room Services 30% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 30% Coinsurance after deductible
Laboratory Outpatient and Professional Services Data Not Available
X-Ray and Diagnostic Imaging Data Not Available

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 $1500 Copay per stay
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy 30% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 30% Coinsurance after deductible
Outpatient Facility 30% Coinsurance after deductible
Outpatient Surgery 30% 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 Pennsylvania

Plan my Connect Blue EPO 250G, a Community Blue Flex Plan Deductible $250 Coinsurance Not applicable Out of Pocket $6,500
Plan my Community Blue Flex PPO 6800B Deductible $6,800 Coinsurance Not applicable Out of Pocket $7,150
Plan my Connect Blue EPO 1000G, a Community Blue Flex Plan Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,500
Plan my Community Blue Flex PPO 1700GQ Deductible $1,700 Coinsurance Not applicable Out of Pocket $3,250
Plan Major Events PPO Blue 7150, a Community Blue Plan Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan my Connect Blue EPO 2500S, a Community Blue Flex Plan Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,150
Plan my Community Blue Flex PPO 2100S Deductible $2,100 Coinsurance Not applicable Out of Pocket $6,900
Plan my Community Blue Flex PPO 2800SQE Deductible $2,800 Coinsurance Not applicable Out of Pocket $5,900
Plan my Connect Blue EPO 1750S, a Community Blue Flex Plan Deductible $1,750 Coinsurance Not applicable Out of Pocket $6,900
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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) $6,500
Deductible (Family) $13,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,150
Out of Pocket Maximum (Family) $14,300

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility $1500 Copay per stay
Inpatient Physician 30% Coinsurance after deductible
Emergency Room Services 30% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 30% Coinsurance after deductible
Laboratory Outpatient and Professional Services Data Not Available
X-Ray and Diagnostic Imaging Data Not Available

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 $1500 Copay per stay
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy 30% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 30% Coinsurance after deductible
Outpatient Facility 30% Coinsurance after deductible
Outpatient Surgery 30% 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 Pennsylvania

Plan my Connect Blue EPO 250G, a Community Blue Flex Plan Deductible $250 Coinsurance Not applicable Out of Pocket $6,500
Plan my Community Blue Flex PPO 6800B Deductible $6,800 Coinsurance Not applicable Out of Pocket $7,150
Plan my Connect Blue EPO 1000G, a Community Blue Flex Plan Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,500
Plan my Community Blue Flex PPO 1700GQ Deductible $1,700 Coinsurance Not applicable Out of Pocket $3,250
Plan Major Events PPO Blue 7150, a Community Blue Plan Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan my Connect Blue EPO 2500S, a Community Blue Flex Plan Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,150
Plan my Community Blue Flex PPO 2100S Deductible $2,100 Coinsurance Not applicable Out of Pocket $6,900
Plan my Community Blue Flex PPO 2800SQE Deductible $2,800 Coinsurance Not applicable Out of Pocket $5,900
Plan my Connect Blue EPO 1750S, a Community Blue Flex Plan Deductible $1,750 Coinsurance Not applicable Out of Pocket $6,900