Highmark - my Direct Blue Conemaugh EPO 7000B

Pennsylvania, 2018

  • Plan Type

    EPO

  • Metal Tier

    Expanded Bronze

  • Out of Pocket Maximum

    $7,350

  • Deductible

    $7,000

Enroll Now
{"state":{"code":"PA","name":"Pennsylvania","fips":42,"exchangeName":["Healthcare.gov"],"exchangeUrl":["http:\/\/www.healthcare.gov"],"exchangeType":["Federal"]},"year":"2018","plan":{"name":"Highmark - my Direct Blue Conemaugh EPO 7000B","planType":"EPO","tier":"Expanded Bronze","oopm":"7350.00","deductible":"7000.00","redirectUrl":"https:\/\/www.healthcare.gov"},"phoneNum":"8558665590"}

Call (855) 866-5590 to speak with a licensed agent about a new health plan.

{"onCurrent":true}

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 30% Coinsurance after deductible
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 Available
Pain Management 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 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 Direct Blue EPO 7000B Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Major Events PPO 7350 a Community Blue Plan Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan my Direct Blue Conemaugh EPO 6950B Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,350
Plan my Direct Blue Conemaugh EPO 1000G Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,500
Plan my Direct Blue EPO 1000G Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,500
Plan my Direct Blue EPO 6950B Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,350
Plan my Direct Blue Conemaugh EPO 7150S Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,350
Plan my Direct Blue EPO 7150S Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,350
{"onCurrent":true,"type":"tools"}

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 30% Coinsurance after deductible
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 Available
Pain Management 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 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 Direct Blue EPO 7000B Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,350
Plan Major Events PPO 7350 a Community Blue Plan Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan my Direct Blue Conemaugh EPO 6950B Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,350
Plan my Direct Blue Conemaugh EPO 1000G Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,500
Plan my Direct Blue EPO 1000G Deductible $1,000 Coinsurance Not applicable Out of Pocket $6,500
Plan my Direct Blue EPO 6950B Deductible $6,950 Coinsurance Not applicable Out of Pocket $7,350
Plan my Direct Blue Conemaugh EPO 7150S Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,350
Plan my Direct Blue EPO 7150S Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,350