Highmark - my Connect Blue WV PPO 1500G

West Virginia, 2018

  • Plan Type

    PPO

  • Metal Tier

    Gold

  • Out of Pocket Maximum

    $5,500

  • Deductible

    $1,500

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) $1,500
Deductible (Family) $3,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $5,500
Out of Pocket Maximum (Family) $11,000

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible
Emergency Room Services Data Not Available

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 20% 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 20% Coinsurance after deductible
Mental / Behavioral Health Outpatient Data Not Available
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 Data Not Available
Preferred Brand Rx Data Not Available
Non Preferred Brand Rx Data Not Available
Specialty Drugs

Other Plans in West Virginia

Plan Major Events Blue PPO 7350 Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan my Connect Blue WV PPO 6500B Deductible $6,500 Coinsurance Not applicable Out of Pocket $7,350
Plan my Connect Blue WV PPO 6000BQE Deductible $6,000 Coinsurance Not applicable Out of Pocket $6,550
Plan my Connect Blue WV PPO 2500S Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan my Connect Blue WV PPO 4750S Deductible $4,750 Coinsurance Not applicable Out of Pocket $7,350
Plan my Connect Blue WV PPO 2800SQE Deductible $2,800 Coinsurance Not applicable Out of Pocket $6,000
Plan my Connect Blue WV PPO 5700S Deductible $5,700 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) $1,500
Deductible (Family) $3,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $5,500
Out of Pocket Maximum (Family) $11,000

Doctor Visits

Primary Care Visit Data Not Available
Specialist Visit Data Not Available
Inpatient Facility 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible
Emergency Room Services Data Not Available

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 20% 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 20% Coinsurance after deductible
Mental / Behavioral Health Outpatient Data Not Available
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 Data Not Available
Preferred Brand Rx Data Not Available
Non Preferred Brand Rx Data Not Available
Specialty Drugs

Other Plans in West Virginia

Plan Major Events Blue PPO 7350 Deductible $7,350 Coinsurance Not applicable Out of Pocket $7,350
Plan my Connect Blue WV PPO 6500B Deductible $6,500 Coinsurance Not applicable Out of Pocket $7,350
Plan my Connect Blue WV PPO 6000BQE Deductible $6,000 Coinsurance Not applicable Out of Pocket $6,550
Plan my Connect Blue WV PPO 2500S Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,350
Plan my Connect Blue WV PPO 4750S Deductible $4,750 Coinsurance Not applicable Out of Pocket $7,350
Plan my Connect Blue WV PPO 2800SQE Deductible $2,800 Coinsurance Not applicable Out of Pocket $6,000
Plan my Connect Blue WV PPO 5700S Deductible $5,700 Coinsurance Not applicable Out of Pocket $7,350