Premera - Premera Blue Cross Preferred Gold 1500

Alaska, 2019

  • Plan Type

    PPO

  • Metal Tier

    Gold

  • Out of Pocket Maximum

    $6,000

  • 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) $6,000
Out of Pocket Maximum (Family) $12,000

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 30% Coinsurance after deductible
X-Ray and Diagnostic Imaging 30% Coinsurance after deductible

Health Management Programs

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

Other

Mental / Behavioral Health Inpatient 30% Coinsurance after deductible
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy $60 Copay after deductible
Rehabilitative Occupational & Physical Therapy $60 Copay 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 50% Coinsurance after deductible
Specialty Drugs 40% Coinsurance after deductible

Other Plans in Alaska

Plan Premera Blue Cross Preferred Silver 3000 HSA Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,600
Plan Premera Blue Cross Preferred Bronze 5250 HSA Deductible $5,250 Coinsurance Not applicable Out of Pocket $6,700
Plan Premera Blue Cross Preferred Bronze 6350 Deductible $6,350 Coinsurance Not applicable Out of Pocket $7,800
Plan Premera Blue Cross Preferred Silver 4500 Deductible $4,500 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) $1,500
Deductible (Family) $3,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $6,000
Out of Pocket Maximum (Family) $12,000

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 30% Coinsurance after deductible
X-Ray and Diagnostic Imaging 30% Coinsurance after deductible

Health Management Programs

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

Other

Mental / Behavioral Health Inpatient 30% Coinsurance after deductible
Mental / Behavioral Health Outpatient Data Not Available
Rehabilitative Speech Therapy $60 Copay after deductible
Rehabilitative Occupational & Physical Therapy $60 Copay 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 50% Coinsurance after deductible
Specialty Drugs 40% Coinsurance after deductible

Other Plans in Alaska

Plan Premera Blue Cross Preferred Silver 3000 HSA Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,600
Plan Premera Blue Cross Preferred Bronze 5250 HSA Deductible $5,250 Coinsurance Not applicable Out of Pocket $6,700
Plan Premera Blue Cross Preferred Bronze 6350 Deductible $6,350 Coinsurance Not applicable Out of Pocket $7,800
Plan Premera Blue Cross Preferred Silver 4500 Deductible $4,500 Coinsurance Not applicable Out of Pocket $7,350