Blue - BlueDirect 80 Silver

North Dakota, 2018

  • Plan Type

    PPO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $6,650

  • Deductible

    $2,700

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) $2,700
Deductible (Family) $5,400
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,650
Out of Pocket Maximum (Family) $13,300

Doctor Visits

Primary Care Visit 20% Coinsurance after deductible
Specialist Visit 20% Coinsurance after deductible
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible
Emergency Room Services 20% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 20% Coinsurance after deductible
Laboratory Outpatient and Professional Services 20% Coinsurance after deductible
X-Ray and Diagnostic Imaging 20% Coinsurance after deductible

Health Management Programs

Asthma Available
Depression Not available
Diabetes Available
Heart Disease Available
High Blood Pressure / High Cholesterol Available
Lower Back Pain Not available
Pain Management Not available
Pregnancy Not available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient 20% Coinsurance after deductible
Mental / Behavioral Health Outpatient 20% Coinsurance after deductible
Rehabilitative Speech Therapy 20% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 20% Coinsurance after deductible
Outpatient Facility 20% Coinsurance after deductible
Outpatient Surgery 20% Coinsurance after deductible

Prescription Drugs

Generic Rx 20% Coinsurance after deductible
Preferred Brand Rx 20% Coinsurance after deductible
Non Preferred Brand Rx 20% Coinsurance after deductible
Specialty Drugs 20% 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) $1,800
Deductible (Family) $3,600
Out of Pocket Maximum (Individual) $5,450
Out of Pocket Maximum (Family) $10,900

Doctor Visits

Primary Care Physician 20% Coinsurance after deductible
Specialists 20% Coinsurance after deductible
Emergency Room 20% Coinsurance after deductible
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible

Prescription Drugs

Generic Rx 20% Coinsurance after deductible
Preferred Brand Rx 20% Coinsurance after deductible
Non Preferred Brand Rx 20% Coinsurance after deductible
Specialty Drugs 20% 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) $700
Deductible (Family) $1,400
Out of Pocket Maximum (Individual) $2,250
Out of Pocket Maximum (Family) $4,500

Doctor Visits

Primary Care Physician 10% Coinsurance after deductible
Specialists 10% Coinsurance after deductible
Emergency Room 10% Coinsurance after deductible
Inpatient Facility 10% Coinsurance after deductible
Inpatient Physician 10% Coinsurance after deductible

Prescription Drugs

Generic Rx 10% Coinsurance after deductible
Preferred Brand Rx 10% Coinsurance after deductible
Non Preferred Brand Rx 10% Coinsurance after deductible
Specialty Drugs 10% Coinsurance after deductible

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) $0
Deductible (Family) $0
Out of Pocket Maximum (Individual) $2,100
Out of Pocket Maximum (Family) $4,200

Doctor Visits

Primary Care Physician
Specialists
Emergency Room
Inpatient Facility
Inpatient Physician

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

Other Plans in North Dakota

Plan BlueDirect 90 Gold Deductible $1,700 Coinsurance Not applicable Out of Pocket $3,675
Plan SimplyBlue 60 Deductible $6,800 Coinsurance Not applicable Out of Pocket $7,350
Plan BlueEssential 100 Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan BlueCare 70 Silver Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan BlueCare 70 Gold Deductible $500 Coinsurance Not applicable Out of Pocket $7,350
Plan BlueDirect 100 Bronze Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650
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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) $2,700
Deductible (Family) $5,400
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,650
Out of Pocket Maximum (Family) $13,300

Doctor Visits

Primary Care Visit 20% Coinsurance after deductible
Specialist Visit 20% Coinsurance after deductible
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible
Emergency Room Services 20% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 20% Coinsurance after deductible
Laboratory Outpatient and Professional Services 20% Coinsurance after deductible
X-Ray and Diagnostic Imaging 20% Coinsurance after deductible

Health Management Programs

Asthma Available
Depression Not available
Diabetes Available
Heart Disease Available
High Blood Pressure / High Cholesterol Available
Lower Back Pain Not available
Pain Management Not available
Pregnancy Not available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient 20% Coinsurance after deductible
Mental / Behavioral Health Outpatient 20% Coinsurance after deductible
Rehabilitative Speech Therapy 20% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 20% Coinsurance after deductible
Outpatient Facility 20% Coinsurance after deductible
Outpatient Surgery 20% Coinsurance after deductible

Prescription Drugs

Generic Rx 20% Coinsurance after deductible
Preferred Brand Rx 20% Coinsurance after deductible
Non Preferred Brand Rx 20% Coinsurance after deductible
Specialty Drugs 20% 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) $1,800
Deductible (Family) $3,600
Out of Pocket Maximum (Individual) $5,450
Out of Pocket Maximum (Family) $10,900

Doctor Visits

Primary Care Physician 20% Coinsurance after deductible
Specialists 20% Coinsurance after deductible
Emergency Room 20% Coinsurance after deductible
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible

Prescription Drugs

Generic Rx 20% Coinsurance after deductible
Preferred Brand Rx 20% Coinsurance after deductible
Non Preferred Brand Rx 20% Coinsurance after deductible
Specialty Drugs 20% 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) $700
Deductible (Family) $1,400
Out of Pocket Maximum (Individual) $2,250
Out of Pocket Maximum (Family) $4,500

Doctor Visits

Primary Care Physician 10% Coinsurance after deductible
Specialists 10% Coinsurance after deductible
Emergency Room 10% Coinsurance after deductible
Inpatient Facility 10% Coinsurance after deductible
Inpatient Physician 10% Coinsurance after deductible

Prescription Drugs

Generic Rx 10% Coinsurance after deductible
Preferred Brand Rx 10% Coinsurance after deductible
Non Preferred Brand Rx 10% Coinsurance after deductible
Specialty Drugs 10% Coinsurance after deductible

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) $0
Deductible (Family) $0
Out of Pocket Maximum (Individual) $2,100
Out of Pocket Maximum (Family) $4,200

Doctor Visits

Primary Care Physician
Specialists
Emergency Room
Inpatient Facility
Inpatient Physician

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

Other Plans in North Dakota

Plan BlueDirect 90 Gold Deductible $1,700 Coinsurance Not applicable Out of Pocket $3,675
Plan SimplyBlue 60 Deductible $6,800 Coinsurance Not applicable Out of Pocket $7,350
Plan BlueEssential 100 Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan BlueCare 70 Silver Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,350
Plan BlueCare 70 Gold Deductible $500 Coinsurance Not applicable Out of Pocket $7,350
Plan BlueDirect 100 Bronze Deductible $6,650 Coinsurance Not applicable Out of Pocket $6,650