Blue - Blue Select 7000 (tiered network)

North Carolina, 2018

  • Plan Type

    PPO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $7,350

  • Deductible

    $7,000

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) $7,000
Deductible (Family) $14,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,350
Out of Pocket Maximum (Family) $14,700

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility $0 Copay per stay + 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible
Emergency Room Services $1000 Copay after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 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 Not available
Pain Management Not available
Pregnancy Available
Weight Loss Available

Other

Mental / Behavioral Health Inpatient 30% Coinsurance after deductible
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy Data Not Available
Rehabilitative Occupational & Physical Therapy Data Not Available
Outpatient Facility 30% Coinsurance after deductible
Outpatient Surgery 30% Coinsurance after deductible

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $40 Copay after deductible
Non Preferred Brand Rx $80 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

73% Cost Sharing Benefits

Households with incomes between 200% to 250% of FPL qualify for the following cost sharing benefits for this silver plan. To understand how cost sharing reductions work and how they work for you see our article about Obamacare Cost Sharing Reduction Discounts

Deductibles and Cost Sharing

Deductible (Individual) $3,900
Deductible (Family) $7,800
Out of Pocket Maximum (Individual) $5,850
Out of Pocket Maximum (Family) $11,700

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $600 Copay after deductible
Inpatient Facility $0 Copay per stay + 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $40 Copay after deductible
Non Preferred Brand Rx $80 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

87% Cost Sharing Benefits

Households with incomes between 150% to 200% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing

Deductible (Individual) $800
Deductible (Family) $1,600
Out of Pocket Maximum (Individual) $2,450
Out of Pocket Maximum (Family) $4,900

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $300 Copay after deductible
Inpatient Facility $0 Copay per stay + 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

94% Cost Sharing Benefits

Households with incomes between 138% to 150% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing

Deductible (Individual) $400
Deductible (Family) $800
Out of Pocket Maximum (Individual) $800
Out of Pocket Maximum (Family) $1,600

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $300 Copay after deductible
Inpatient Facility $0 Copay per stay + 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

Other Plans in North Carolina

Plan Blue Local 7000 (local network with Duke Health and WakeMed) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Local 2500 (local network with Duke Health and WakeMed) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Select 2500 (tiered network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Value Catastrophic (limited network) Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Value 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage 7000 (broad network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Value 4000 (limited network) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Value Catastrophic (limited network) Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Local 4000 (local network with Duke Health and WakeMed) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage 6650 (broad network, HSA eligible) Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Blue Local 2500 (local network with Carolinas HealthCare System) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Local 7000 (local network with Carolinas HealthCare System) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage 4000 (broad network) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Value 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage 2500 (broad network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Select 7000 (tiered network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Value 2500 (limited network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Value 6650 (limited network, HSA eligible) Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Blue Value 6650 (limited network, HSA eligible) Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Blue Select 2500 (tiered network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Local 6650 (local network with Carolinas HealthCare System, HSA eligible) Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Blue Value 4000 (limited network) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Local 6650 (local network with Duke Health and WakeMed, HSA eligible) Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Blue Local 4000 (local network with Carolinas HealthCare System) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Catastrophic (broad network) Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Value 2500 (limited network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
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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) $7,000
Deductible (Family) $14,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,350
Out of Pocket Maximum (Family) $14,700

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility $0 Copay per stay + 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible
Emergency Room Services $1000 Copay after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 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 Not available
Pain Management Not available
Pregnancy Available
Weight Loss Available

Other

Mental / Behavioral Health Inpatient 30% Coinsurance after deductible
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy Data Not Available
Rehabilitative Occupational & Physical Therapy Data Not Available
Outpatient Facility 30% Coinsurance after deductible
Outpatient Surgery 30% Coinsurance after deductible

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $40 Copay after deductible
Non Preferred Brand Rx $80 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

73% Cost Sharing Benefits

Households with incomes between 200% to 250% of FPL qualify for the following cost sharing benefits for this silver plan. To understand how cost sharing reductions work and how they work for you see our article about Obamacare Cost Sharing Reduction Discounts

Deductibles and Cost Sharing

Deductible (Individual) $3,900
Deductible (Family) $7,800
Out of Pocket Maximum (Individual) $5,850
Out of Pocket Maximum (Family) $11,700

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $600 Copay after deductible
Inpatient Facility $0 Copay per stay + 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $40 Copay after deductible
Non Preferred Brand Rx $80 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

87% Cost Sharing Benefits

Households with incomes between 150% to 200% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing

Deductible (Individual) $800
Deductible (Family) $1,600
Out of Pocket Maximum (Individual) $2,450
Out of Pocket Maximum (Family) $4,900

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $300 Copay after deductible
Inpatient Facility $0 Copay per stay + 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

94% Cost Sharing Benefits

Households with incomes between 138% to 150% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing

Deductible (Individual) $400
Deductible (Family) $800
Out of Pocket Maximum (Individual) $800
Out of Pocket Maximum (Family) $1,600

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $300 Copay after deductible
Inpatient Facility $0 Copay per stay + 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

Other Plans in North Carolina

Plan Blue Local 7000 (local network with Duke Health and WakeMed) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Local 2500 (local network with Duke Health and WakeMed) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Select 2500 (tiered network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Value Catastrophic (limited network) Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Value 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage 7000 (broad network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Value 4000 (limited network) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Value Catastrophic (limited network) Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Local 4000 (local network with Duke Health and WakeMed) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage 6650 (broad network, HSA eligible) Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Blue Local 2500 (local network with Carolinas HealthCare System) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Local 7000 (local network with Carolinas HealthCare System) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage 4000 (broad network) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Value 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage 2500 (broad network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Select 7000 (tiered network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Value 2500 (limited network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Value 6650 (limited network, HSA eligible) Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Blue Value 6650 (limited network, HSA eligible) Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Blue Select 2500 (tiered network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Local 6650 (local network with Carolinas HealthCare System, HSA eligible) Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Blue Value 4000 (limited network) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Local 6650 (local network with Duke Health and WakeMed, HSA eligible) Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
Plan Blue Local 4000 (local network with Carolinas HealthCare System) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Catastrophic (broad network) Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Value 2500 (limited network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350