Blue - Blue Advantage Bronze PPO? 203

Oklahoma, 2018

  • Plan Type

    PPO

  • Metal Tier

    Bronze

  • Out of Pocket Maximum

    $6,550

  • Deductible

    $2,850

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) $2,850
Deductible (Family) $8,550
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,550
Out of Pocket Maximum (Family) $13,100

Doctor Visits

Primary Care Visit 40% Coinsurance after deductible
Specialist Visit 40% Coinsurance after deductible
Inpatient Facility $400 Copay per stay after deductible + 40% Coinsurance after deductible
Inpatient Physician 40% Coinsurance after deductible
Emergency Room Services $950 Copay after deductible + 40% Coinsurance 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 Available
Pain Management Available
Pregnancy Available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient $400 Copay per stay after deductible + 40% Coinsurance after deductible
Mental / Behavioral Health Outpatient 40% Coinsurance after deductible
Rehabilitative Speech Therapy 40% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 40% Coinsurance after deductible
Outpatient Facility $300 Copay after deductible + 30% Coinsurance after deductible
Outpatient Surgery $300 Copay after deductible + 30% Coinsurance after deductible

Prescription Drugs

Generic Rx 20% Coinsurance after deductible
Preferred Brand Rx 30% Coinsurance after deductible
Non Preferred Brand Rx 35% Coinsurance after deductible
Specialty Drugs 45% Coinsurance after deductible

Other Plans in Oklahoma

Plan Blue Preferred Gold PPO? 205 Deductible $200 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Gold PPO? 205 Deductible $200 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Bronze PPO? 203 Deductible $2,850 Coinsurance Not applicable Out of Pocket $6,550
Plan Blue Preferred Bronze PPO? 206 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Bronze PPO? 202 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Silver PPO? 201 Deductible $1,450 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Silver PPO? 201 Deductible $1,450 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Silver PPO? 204 Deductible $1,400 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Bronze PPO? 203 Deductible $2,850 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 Advantage Bronze PPO? 202 Deductible $4,700 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 Advantage Silver PPO? 204 Deductible $1,400 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Silver PPO? 204 Deductible $1,400 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Bronze PPO? 202 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Silver PPO? 201 Deductible $1,450 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Bronze PPO? 203 Deductible $2,850 Coinsurance Not applicable Out of Pocket $6,550
Plan Blue Preferred Bronze PPO? 206 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Gold PPO? 205 Deductible $200 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Bronze PPO? 203 Deductible $2,850 Coinsurance Not applicable Out of Pocket $6,550
Plan Blue Preferred Bronze PPO? 206 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Gold PPO? 205 Deductible $200 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Silver PPO? 204 Deductible $1,400 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Bronze PPO? 206 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Bronze PPO? 202 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Silver PPO? 204 Deductible $1,400 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Silver PPO? 201 Deductible $1,450 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 Advantage Bronze PPO? 202 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Silver PPO? 201 Deductible $1,450 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Bronze PPO? 206 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Gold PPO? 205 Deductible $200 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) $2,850
Deductible (Family) $8,550
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,550
Out of Pocket Maximum (Family) $13,100

Doctor Visits

Primary Care Visit 40% Coinsurance after deductible
Specialist Visit 40% Coinsurance after deductible
Inpatient Facility $400 Copay per stay after deductible + 40% Coinsurance after deductible
Inpatient Physician 40% Coinsurance after deductible
Emergency Room Services $950 Copay after deductible + 40% Coinsurance 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 Available
Pain Management Available
Pregnancy Available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient $400 Copay per stay after deductible + 40% Coinsurance after deductible
Mental / Behavioral Health Outpatient 40% Coinsurance after deductible
Rehabilitative Speech Therapy 40% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 40% Coinsurance after deductible
Outpatient Facility $300 Copay after deductible + 30% Coinsurance after deductible
Outpatient Surgery $300 Copay after deductible + 30% Coinsurance after deductible

Prescription Drugs

Generic Rx 20% Coinsurance after deductible
Preferred Brand Rx 30% Coinsurance after deductible
Non Preferred Brand Rx 35% Coinsurance after deductible
Specialty Drugs 45% Coinsurance after deductible

Other Plans in Oklahoma

Plan Blue Preferred Gold PPO? 205 Deductible $200 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Gold PPO? 205 Deductible $200 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Bronze PPO? 203 Deductible $2,850 Coinsurance Not applicable Out of Pocket $6,550
Plan Blue Preferred Bronze PPO? 206 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Bronze PPO? 202 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Silver PPO? 201 Deductible $1,450 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Silver PPO? 201 Deductible $1,450 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Silver PPO? 204 Deductible $1,400 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Bronze PPO? 203 Deductible $2,850 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 Advantage Bronze PPO? 202 Deductible $4,700 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 Advantage Silver PPO? 204 Deductible $1,400 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Silver PPO? 204 Deductible $1,400 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Bronze PPO? 202 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Silver PPO? 201 Deductible $1,450 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Bronze PPO? 203 Deductible $2,850 Coinsurance Not applicable Out of Pocket $6,550
Plan Blue Preferred Bronze PPO? 206 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Gold PPO? 205 Deductible $200 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Bronze PPO? 203 Deductible $2,850 Coinsurance Not applicable Out of Pocket $6,550
Plan Blue Preferred Bronze PPO? 206 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Gold PPO? 205 Deductible $200 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Silver PPO? 204 Deductible $1,400 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Bronze PPO? 206 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Bronze PPO? 202 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Advantage Silver PPO? 204 Deductible $1,400 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Silver PPO? 201 Deductible $1,450 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 Advantage Bronze PPO? 202 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Silver PPO? 201 Deductible $1,450 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Bronze PPO? 206 Deductible $4,700 Coinsurance Not applicable Out of Pocket $7,350
Plan Blue Preferred Gold PPO? 205 Deductible $200 Coinsurance Not applicable Out of Pocket $7,350