Blue - Blue Preferred Silver PPO? 203

Montana, 2019

  • Plan Type

    PPO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $7,900

  • Deductible

    $650

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) $650
Deductible (Family) $1,300
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,900
Out of Pocket Maximum (Family) $15,800

Doctor Visits

Primary Care Visit 40% Coinsurance after deductible
Specialist Visit 50% Coinsurance after deductible
Inpatient Facility $850 Copay per stay after deductible + 50% Coinsurance after deductible
Inpatient Physician 50% Coinsurance after deductible
Emergency Room Services $1000 Copay after deductible + 50% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 50% Coinsurance after deductible
Laboratory Outpatient and Professional Services 50% Coinsurance after deductible
X-Ray and Diagnostic Imaging 50% 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 $850 Copay per stay after deductible + 50% Coinsurance after deductible
Mental / Behavioral Health Outpatient 40% Coinsurance after deductible
Rehabilitative Speech Therapy 50% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 50% Coinsurance after deductible
Outpatient Facility $600 Copay after deductible + 50% Coinsurance after deductible
Outpatient Surgery 50% 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

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) $650
Deductible (Family) $1,300
Out of Pocket Maximum (Individual) $6,300
Out of Pocket Maximum (Family) $12,600

Doctor Visits

Primary Care Physician 40% Coinsurance after deductible
Specialists 50% Coinsurance after deductible
Emergency Room $1000 Copay after deductible + 50% Coinsurance after deductible
Inpatient Facility $850 Copay per stay after deductible + 50% Coinsurance after deductible
Inpatient Physician 50% 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

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) $150
Deductible (Family) $300
Out of Pocket Maximum (Individual) $2,600
Out of Pocket Maximum (Family) $5,200

Doctor Visits

Primary Care Physician 20% Coinsurance after deductible
Specialists 30% Coinsurance after deductible
Emergency Room $500 Copay after deductible + 30% Coinsurance after deductible
Inpatient Facility $250 Copay per stay after deductible + 30% Coinsurance after deductible
Inpatient Physician 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

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) $125
Deductible (Family) $250
Out of Pocket Maximum (Individual) $900
Out of Pocket Maximum (Family) $1,800

Doctor Visits

Primary Care Physician 10% Coinsurance after deductible
Specialists 20% Coinsurance after deductible
Emergency Room $500 Copay after deductible + 20% Coinsurance after deductible
Inpatient Facility $250 Copay per stay after deductible + 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible

Prescription Drugs

Generic Rx No charge after deductible
Preferred Brand Rx 20% Coinsurance after deductible
Non Preferred Brand Rx 35% Coinsurance after deductible
Specialty Drugs 45% Coinsurance after deductible

Other Plans in Montana

Plan Blue Focus Bronze POS? 205 - Two $40 PCP Visits Deductible $4,400 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Silver PPO? 203 Deductible $650 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 201 - Two $25 PCP Visits Deductible $2,850 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Security PPO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Focus Gold POS? 207 Deductible $0 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Focus Silver POS? 206 - Two $25 PCP Visits Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 201 - Two $25 PCP Visits Deductible $2,850 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Silver PPO? 308 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Silver PPO? 203 Deductible $650 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Focus Gold POS? 207 Deductible $0 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Silver PPO? 308 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Silver PPO? 203 Deductible $650 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Focus Bronze POS? 205 - Two $40 PCP Visits Deductible $4,400 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 202 Deductible $2,900 Coinsurance Not applicable Out of Pocket $6,650
Plan Blue Preferred Security PPO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Gold PPO? 204 - Two $10 PCP Visits Deductible $450 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 201 - Two $25 PCP Visits Deductible $2,850 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 202 Deductible $2,900 Coinsurance Not applicable Out of Pocket $6,650
Plan Blue Preferred Bronze PPO? 201 - Two $25 PCP Visits Deductible $2,850 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 202 Deductible $2,900 Coinsurance Not applicable Out of Pocket $6,650
Plan Blue Preferred Bronze PPO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Gold PPO? 204 - Two $10 PCP Visits Deductible $450 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Silver PPO? 308 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Gold PPO? 204 - Two $10 PCP Visits Deductible $450 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Focus Silver POS? 206 - Two $25 PCP Visits Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Gold PPO? 204 - Two $10 PCP Visits Deductible $450 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Security PPO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Security PPO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Silver PPO? 308 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 202 Deductible $2,900 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) $650
Deductible (Family) $1,300
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,900
Out of Pocket Maximum (Family) $15,800

Doctor Visits

Primary Care Visit 40% Coinsurance after deductible
Specialist Visit 50% Coinsurance after deductible
Inpatient Facility $850 Copay per stay after deductible + 50% Coinsurance after deductible
Inpatient Physician 50% Coinsurance after deductible
Emergency Room Services $1000 Copay after deductible + 50% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 50% Coinsurance after deductible
Laboratory Outpatient and Professional Services 50% Coinsurance after deductible
X-Ray and Diagnostic Imaging 50% 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 $850 Copay per stay after deductible + 50% Coinsurance after deductible
Mental / Behavioral Health Outpatient 40% Coinsurance after deductible
Rehabilitative Speech Therapy 50% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 50% Coinsurance after deductible
Outpatient Facility $600 Copay after deductible + 50% Coinsurance after deductible
Outpatient Surgery 50% 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

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) $650
Deductible (Family) $1,300
Out of Pocket Maximum (Individual) $6,300
Out of Pocket Maximum (Family) $12,600

Doctor Visits

Primary Care Physician 40% Coinsurance after deductible
Specialists 50% Coinsurance after deductible
Emergency Room $1000 Copay after deductible + 50% Coinsurance after deductible
Inpatient Facility $850 Copay per stay after deductible + 50% Coinsurance after deductible
Inpatient Physician 50% 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

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) $150
Deductible (Family) $300
Out of Pocket Maximum (Individual) $2,600
Out of Pocket Maximum (Family) $5,200

Doctor Visits

Primary Care Physician 20% Coinsurance after deductible
Specialists 30% Coinsurance after deductible
Emergency Room $500 Copay after deductible + 30% Coinsurance after deductible
Inpatient Facility $250 Copay per stay after deductible + 30% Coinsurance after deductible
Inpatient Physician 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

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) $125
Deductible (Family) $250
Out of Pocket Maximum (Individual) $900
Out of Pocket Maximum (Family) $1,800

Doctor Visits

Primary Care Physician 10% Coinsurance after deductible
Specialists 20% Coinsurance after deductible
Emergency Room $500 Copay after deductible + 20% Coinsurance after deductible
Inpatient Facility $250 Copay per stay after deductible + 20% Coinsurance after deductible
Inpatient Physician 20% Coinsurance after deductible

Prescription Drugs

Generic Rx No charge after deductible
Preferred Brand Rx 20% Coinsurance after deductible
Non Preferred Brand Rx 35% Coinsurance after deductible
Specialty Drugs 45% Coinsurance after deductible

Other Plans in Montana

Plan Blue Focus Bronze POS? 205 - Two $40 PCP Visits Deductible $4,400 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Silver PPO? 203 Deductible $650 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 201 - Two $25 PCP Visits Deductible $2,850 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Security PPO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Focus Gold POS? 207 Deductible $0 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Focus Silver POS? 206 - Two $25 PCP Visits Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 201 - Two $25 PCP Visits Deductible $2,850 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Silver PPO? 308 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Silver PPO? 203 Deductible $650 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Focus Gold POS? 207 Deductible $0 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Silver PPO? 308 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Silver PPO? 203 Deductible $650 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Focus Bronze POS? 205 - Two $40 PCP Visits Deductible $4,400 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 202 Deductible $2,900 Coinsurance Not applicable Out of Pocket $6,650
Plan Blue Preferred Security PPO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Gold PPO? 204 - Two $10 PCP Visits Deductible $450 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 201 - Two $25 PCP Visits Deductible $2,850 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 202 Deductible $2,900 Coinsurance Not applicable Out of Pocket $6,650
Plan Blue Preferred Bronze PPO? 201 - Two $25 PCP Visits Deductible $2,850 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 202 Deductible $2,900 Coinsurance Not applicable Out of Pocket $6,650
Plan Blue Preferred Bronze PPO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Gold PPO? 204 - Two $10 PCP Visits Deductible $450 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Silver PPO? 308 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Gold PPO? 204 - Two $10 PCP Visits Deductible $450 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Focus Silver POS? 206 - Two $25 PCP Visits Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Gold PPO? 204 - Two $10 PCP Visits Deductible $450 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Security PPO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Security PPO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Silver PPO? 308 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Preferred Bronze PPO? 202 Deductible $2,900 Coinsurance Not applicable Out of Pocket $6,650