Plan
Blue Preferred Gold PPO? 204 - Two $10 PCP Visits
|
Deductible
$450 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Preferred Security PPO? 200
|
Deductible
$7,350 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Preferred Security PPO? 200
|
Deductible
$7,350 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Preferred Silver PPO? 203
|
Deductible
$1,000 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Preferred Bronze PPO? 202
|
Deductible
$2,700 |
Coinsurance Not applicable |
Out of Pocket
$6,550 |
Plan
Blue Preferred Bronze PPO? 202
|
Deductible
$2,700 |
Coinsurance Not applicable |
Out of Pocket
$6,550 |
Plan
Blue Preferred Bronze PPO? 201 - Two $25 PCP Visits
|
Deductible
$2,850 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Preferred Bronze PPO? 202
|
Deductible
$2,700 |
Coinsurance Not applicable |
Out of Pocket
$6,550 |
Plan
Blue Preferred Gold PPO? 204 - Two $10 PCP Visits
|
Deductible
$450 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Focus Silver POS? 206 - Two $25 PCP Visits
|
Deductible
$3,500 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Preferred Gold PPO? 204 - Two $10 PCP Visits
|
Deductible
$450 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Preferred Silver PPO? 203
|
Deductible
$1,000 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Preferred Bronze PPO? 202
|
Deductible
$2,700 |
Coinsurance Not applicable |
Out of Pocket
$6,550 |
Plan
Blue Preferred Security PPO? 200
|
Deductible
$7,350 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Preferred Bronze PPO? 201 - Two $25 PCP Visits
|
Deductible
$2,850 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Preferred Gold PPO?204 - Two $10 PCP Visits
|
Deductible
$450 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Focus Bronze POS? 205 - Two $40 PCP Visits
|
Deductible
$4,000 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Preferred Bronze PPO? 201 - Two $25 PCP Visits
|
Deductible
$2,850 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Preferred Silver PPO? 203
|
Deductible
$1,000 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Preferred Security PPO? 200
|
Deductible
$7,350 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Focus Gold POS? 207
|
Deductible
$0 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Preferred Bronze PPO? 201 - Two $25 PCP Visits
|
Deductible
$2,850 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Focus Silver POS? 206 - Two $25 PCP Visits
|
Deductible
$3,500 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Focus Gold POS? 207
|
Deductible
$0 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Blue Preferred Silver PPO? 203
|
Deductible
$1,000 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |