Blue - Blue Value Silver 4000 (limited network)

North Carolina, 2019

  • Plan Type

    POS

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $7,900

  • Deductible

    $4,000

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) $4,000
Deductible (Family) $8,000
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 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible
Emergency Room Services $600 Copay 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 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 30% 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 30% Coinsurance after deductible
Outpatient Surgery 30% Coinsurance after deductible

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $40 Copay after deductible
Non Preferred Brand Rx $80 Copay after deductible
Specialty Drugs 25% 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) $3,700
Deductible (Family) $7,400
Out of Pocket Maximum (Individual) $6,300
Out of Pocket Maximum (Family) $12,600

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $600 Copay after deductible
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $40 Copay after deductible
Non Preferred Brand Rx $80 Copay after deductible
Specialty Drugs 25% 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) $600
Deductible (Family) $1,200
Out of Pocket Maximum (Individual) $2,500
Out of Pocket Maximum (Family) $5,000

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $500 Copay after deductible
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

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) $200
Deductible (Family) $400
Out of Pocket Maximum (Individual) $600
Out of Pocket Maximum (Family) $1,200

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $200 Copay after deductible
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

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 Select Gold 2500 (tiered 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 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
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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) $4,000
Deductible (Family) $8,000
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 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible
Emergency Room Services $600 Copay 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 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 30% 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 30% Coinsurance after deductible
Outpatient Surgery 30% Coinsurance after deductible

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $40 Copay after deductible
Non Preferred Brand Rx $80 Copay after deductible
Specialty Drugs 25% 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) $3,700
Deductible (Family) $7,400
Out of Pocket Maximum (Individual) $6,300
Out of Pocket Maximum (Family) $12,600

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $600 Copay after deductible
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible

Prescription Drugs

Generic Rx $10 Copay after deductible
Preferred Brand Rx $40 Copay after deductible
Non Preferred Brand Rx $80 Copay after deductible
Specialty Drugs 25% 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) $600
Deductible (Family) $1,200
Out of Pocket Maximum (Individual) $2,500
Out of Pocket Maximum (Family) $5,000

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $500 Copay after deductible
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

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) $200
Deductible (Family) $400
Out of Pocket Maximum (Individual) $600
Out of Pocket Maximum (Family) $1,200

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $200 Copay after deductible
Inpatient Facility 30% Coinsurance after deductible
Inpatient Physician 30% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

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 Select Gold 2500 (tiered 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 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