Blue - Blue Select Gold 2500 (tiered network)

North Carolina, 2019

  • Plan Type

    PPO

  • Metal Tier

    Gold

  • Out of Pocket Maximum

    $7,900

  • Deductible

    $2,500

Enroll Now
{"state":{"code":"NC","name":"North Carolina","fips":37,"exchangeName":["Healthcare.gov"],"exchangeUrl":["http:\/\/www.healthcare.gov"],"exchangeType":["Federal"]},"year":"2019","plan":{"name":"Blue - Blue Select Gold 2500 (tiered network)","planType":"PPO","tier":"Gold","oopm":"7900.00","deductible":"2500.00","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) $2,500
Deductible (Family) $5,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,900
Out of Pocket Maximum (Family) $15,800

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 $500 Copay after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 20% Coinsurance after deductible
Laboratory Outpatient and Professional Services 20% Coinsurance after deductible
X-Ray and Diagnostic Imaging 20% Coinsurance after deductible

Health Management Programs

Asthma Available
Depression Available
Diabetes Available
Heart Disease Available
High Blood Pressure / High Cholesterol Available
Lower Back Pain Not available
Pain Management Not 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 Data Not Available
Rehabilitative Occupational & Physical Therapy Data Not Available
Outpatient Facility 20% Coinsurance after deductible
Outpatient Surgery 20% Coinsurance after deductible

Prescription Drugs

Generic Rx $4 Copay after deductible
Preferred Brand Rx $35 Copay after deductible
Non Preferred Brand Rx $80 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

Other Plans in North Carolina

Plan Blue Advantage Silver 4000 (broad network) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7900 (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Gold 2500 (limited network with UNC Health Alliance) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 6750 (limited network, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Value Bronze 6750 (limited network, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Local Catastrophic (local network with Atrium Health) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Select Gold 2500 (tiered network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Catastrophic (broad network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Catastrophic (limited network with UNC Health Alliance) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Local Bronze 6750 (local network with Atrium Health, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Value Silver 4000 (limited network) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Silver 4000 (limited network) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Silver 7000 (limited network with UNC Health Alliance) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Catastrophic (broad network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Local Silver 4000 (local network with Atrium Health) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Gold 2500 (limited network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Local Gold 2500 (local network with Atrium Health) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Silver 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7000 (limited network with UNC Health Alliance) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver 4000 (broad network) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Local Silver 7000 (local network with Atrium Health) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Silver 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Silver 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Catastrophic (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold 2500 (broad network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Select Silver 7000 (tiered network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Local Bronze 7900 (local network with Atrium Health) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Gold 2500 (limited network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Select Silver 7000 (tiered network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze 7000 (broad network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Gold 2500 (limited network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Gold 2500 (limited network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver 7000 (broad network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze 6750 (broad network, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Value Bronze 7900 (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze 7900 (broad network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 6750 (limited network, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Value Bronze 7900 (limited network with UNC Health Alliance) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Catastrophic (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 6750 (limited network, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Value Catastrophic (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 6750 (limited network, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Advantage Bronze 6750 (broad network, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Value Silver 4000 (limited network) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Catastrophic (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Silver 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Silver 4000 (limited network with UNC Health Alliance) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7900 (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Local Bronze 7000 (local network with Atrium Health) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Gold 2500 (limited network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Select Gold 2500 (tiered network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze 7900 (broad network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 6750 (limited network with UNC Health Alliance, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Value Catastrophic (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7900 (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze 7000 (broad network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7900 (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Silver 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Select Gold 2500 (tiered network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold 2500 (broad network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
{"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) $2,500
Deductible (Family) $5,000
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,900
Out of Pocket Maximum (Family) $15,800

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 $500 Copay after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 20% Coinsurance after deductible
Laboratory Outpatient and Professional Services 20% Coinsurance after deductible
X-Ray and Diagnostic Imaging 20% Coinsurance after deductible

Health Management Programs

Asthma Available
Depression Available
Diabetes Available
Heart Disease Available
High Blood Pressure / High Cholesterol Available
Lower Back Pain Not available
Pain Management Not 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 Data Not Available
Rehabilitative Occupational & Physical Therapy Data Not Available
Outpatient Facility 20% Coinsurance after deductible
Outpatient Surgery 20% Coinsurance after deductible

Prescription Drugs

Generic Rx $4 Copay after deductible
Preferred Brand Rx $35 Copay after deductible
Non Preferred Brand Rx $80 Copay after deductible
Specialty Drugs 25% Coinsurance after deductible

Other Plans in North Carolina

Plan Blue Advantage Silver 4000 (broad network) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7900 (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Gold 2500 (limited network with UNC Health Alliance) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 6750 (limited network, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Value Bronze 6750 (limited network, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Local Catastrophic (local network with Atrium Health) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Select Gold 2500 (tiered network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Catastrophic (broad network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Catastrophic (limited network with UNC Health Alliance) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Local Bronze 6750 (local network with Atrium Health, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Value Silver 4000 (limited network) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Silver 4000 (limited network) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Silver 7000 (limited network with UNC Health Alliance) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Catastrophic (broad network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Local Silver 4000 (local network with Atrium Health) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Gold 2500 (limited network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Local Gold 2500 (local network with Atrium Health) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Silver 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7000 (limited network with UNC Health Alliance) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver 4000 (broad network) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Local Silver 7000 (local network with Atrium Health) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Silver 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Silver 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Catastrophic (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold 2500 (broad network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Select Silver 7000 (tiered network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Local Bronze 7900 (local network with Atrium Health) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Gold 2500 (limited network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Select Silver 7000 (tiered network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze 7000 (broad network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Gold 2500 (limited network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Gold 2500 (limited network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver 7000 (broad network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze 6750 (broad network, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Value Bronze 7900 (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze 7900 (broad network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 6750 (limited network, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Value Bronze 7900 (limited network with UNC Health Alliance) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Catastrophic (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 6750 (limited network, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Value Catastrophic (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 6750 (limited network, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Advantage Bronze 6750 (broad network, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Value Silver 4000 (limited network) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Catastrophic (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Silver 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Silver 4000 (limited network with UNC Health Alliance) Deductible $4,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7900 (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Local Bronze 7000 (local network with Atrium Health) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Gold 2500 (limited network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Select Gold 2500 (tiered network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze 7900 (broad network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 6750 (limited network with UNC Health Alliance, HSA eligible) Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan Blue Value Catastrophic (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7900 (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze 7000 (broad network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Bronze 7900 (limited network) Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Value Silver 7000 (limited network) Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Select Gold 2500 (tiered network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold 2500 (broad network) Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,900