Blue - BlueEssentials Silver 8

South Carolina, 2019

  • Plan Type

    EPO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $7,900

  • Deductible

    $5,250

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) $5,250
Deductible (Family) $10,500
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 15% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible
Emergency Room Services $300 Copay after deductible + 15% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 15% Coinsurance after deductible
Laboratory Outpatient and Professional Services 15% Coinsurance after deductible
X-Ray and Diagnostic Imaging 15% Coinsurance after deductible

Health Management Programs

Asthma Not available
Depression Not available
Diabetes Not available
Heart Disease Not 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 15% Coinsurance after deductible
Mental / Behavioral Health Outpatient 15% Coinsurance after deductible
Rehabilitative Speech Therapy 15% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 15% Coinsurance after deductible
Outpatient Facility 15% Coinsurance after deductible
Outpatient Surgery 15% 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

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) $4,800
Deductible (Family) $9,600
Out of Pocket Maximum (Individual) $6,300
Out of Pocket Maximum (Family) $12,600

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $300 Copay after deductible + 15% Coinsurance after deductible
Inpatient Facility 15% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

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) $850
Deductible (Family) $1,700
Out of Pocket Maximum (Individual) $2,250
Out of Pocket Maximum (Family) $4,500

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $300 Copay after deductible + 10% Coinsurance after deductible
Inpatient Facility 10% Coinsurance after deductible
Inpatient Physician 10% 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) $0
Deductible (Family) $0
Out of Pocket Maximum (Individual) $2,250
Out of Pocket Maximum (Family) $4,500

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $300 Copay after deductible + 5% Coinsurance after deductible
Inpatient Facility 5% Coinsurance after deductible
Inpatient Physician 5% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

Other Plans in South Carolina

Plan BlueEssentials HD Bronze 5 Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan BlueEssentials Silver 12 Deductible $4,800 Coinsurance Not applicable Out of Pocket $7,350
Plan BlueEssentials Silver 4 Deductible $3,100 Coinsurance Not applicable Out of Pocket $7,900
Plan BlueEssentials HD Bronze 3 Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,750
Plan BlueEssentials Bronze 1 Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan BlueEssentials Silver 33 Deductible $6,600 Coinsurance Not applicable Out of Pocket $7,900
Plan BlueEssentials Silver 10 Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan BlueEssentials Silver 2 Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,600
Plan BlueEssentials Silver 1 Deductible $690 Coinsurance Not applicable Out of Pocket $7,900
Plan BlueEssentials Silver 11 Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,150
Plan BlueEssentials Silver 34 Deductible $6,800 Coinsurance Not applicable Out of Pocket $7,900
Plan BlueEssentials Silver 3 Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,500
Plan BlueEssentials Bronze 4 Deductible $6,400 Coinsurance Not applicable Out of Pocket $7,900
Plan BlueEssentials HD Gold 3 Deductible $3,000 Coinsurance Not applicable Out of Pocket $3,000
Plan BlueEssentials Silver 7 Deductible $6,400 Coinsurance Not applicable Out of Pocket $7,150
Plan BlueEssentials Gold 4 Deductible $2,700 Coinsurance Not applicable Out of Pocket $6,000
Plan BlueEssentials Silver 29 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan BlueEssentials Silver 9 Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,850
Plan BlueEssentials Silver 14 Deductible $6,650 Coinsurance Not applicable Out of Pocket $7,150
Plan BlueEssentials HD Silver 6 Deductible $4,300 Coinsurance Not applicable Out of Pocket $4,300
Plan BlueEssentials HD Bronze 2 Deductible $6,300 Coinsurance Not applicable Out of Pocket $6,750
Plan BlueEssentials Catastrophic 1 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan BlueEssentials Gold 1 Deductible $2,000 Coinsurance Not applicable Out of Pocket $4,500
Plan BlueEssentials Gold 2 Deductible $1,500 Coinsurance Not applicable Out of Pocket $5,000
Plan BlueEssentials HD Silver 5 Deductible $3,300 Coinsurance Not applicable Out of Pocket $5,000
Plan BlueEssentials HD Silver 13 Deductible $4,550 Coinsurance Not applicable Out of Pocket $4,550
Plan BlueEssentials Silver 30 Deductible $6,900 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) $5,250
Deductible (Family) $10,500
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 15% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible
Emergency Room Services $300 Copay after deductible + 15% Coinsurance after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 15% Coinsurance after deductible
Laboratory Outpatient and Professional Services 15% Coinsurance after deductible
X-Ray and Diagnostic Imaging 15% Coinsurance after deductible

Health Management Programs

Asthma Not available
Depression Not available
Diabetes Not available
Heart Disease Not 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 15% Coinsurance after deductible
Mental / Behavioral Health Outpatient 15% Coinsurance after deductible
Rehabilitative Speech Therapy 15% Coinsurance after deductible
Rehabilitative Occupational & Physical Therapy 15% Coinsurance after deductible
Outpatient Facility 15% Coinsurance after deductible
Outpatient Surgery 15% 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

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) $4,800
Deductible (Family) $9,600
Out of Pocket Maximum (Individual) $6,300
Out of Pocket Maximum (Family) $12,600

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $300 Copay after deductible + 15% Coinsurance after deductible
Inpatient Facility 15% Coinsurance after deductible
Inpatient Physician 15% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

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) $850
Deductible (Family) $1,700
Out of Pocket Maximum (Individual) $2,250
Out of Pocket Maximum (Family) $4,500

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $300 Copay after deductible + 10% Coinsurance after deductible
Inpatient Facility 10% Coinsurance after deductible
Inpatient Physician 10% 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) $0
Deductible (Family) $0
Out of Pocket Maximum (Individual) $2,250
Out of Pocket Maximum (Family) $4,500

Doctor Visits

Primary Care Physician
Specialists
Emergency Room $300 Copay after deductible + 5% Coinsurance after deductible
Inpatient Facility 5% Coinsurance after deductible
Inpatient Physician 5% Coinsurance after deductible

Prescription Drugs

Generic Rx
Preferred Brand Rx
Non Preferred Brand Rx
Specialty Drugs

Other Plans in South Carolina

Plan BlueEssentials HD Bronze 5 Deductible $6,750 Coinsurance Not applicable Out of Pocket $6,750
Plan BlueEssentials Silver 12 Deductible $4,800 Coinsurance Not applicable Out of Pocket $7,350
Plan BlueEssentials Silver 4 Deductible $3,100 Coinsurance Not applicable Out of Pocket $7,900
Plan BlueEssentials HD Bronze 3 Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,750
Plan BlueEssentials Bronze 1 Deductible $7,000 Coinsurance Not applicable Out of Pocket $7,900
Plan BlueEssentials Silver 33 Deductible $6,600 Coinsurance Not applicable Out of Pocket $7,900
Plan BlueEssentials Silver 10 Deductible $7,150 Coinsurance Not applicable Out of Pocket $7,150
Plan BlueEssentials Silver 2 Deductible $3,000 Coinsurance Not applicable Out of Pocket $6,600
Plan BlueEssentials Silver 1 Deductible $690 Coinsurance Not applicable Out of Pocket $7,900
Plan BlueEssentials Silver 11 Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,150
Plan BlueEssentials Silver 34 Deductible $6,800 Coinsurance Not applicable Out of Pocket $7,900
Plan BlueEssentials Silver 3 Deductible $3,500 Coinsurance Not applicable Out of Pocket $7,500
Plan BlueEssentials Bronze 4 Deductible $6,400 Coinsurance Not applicable Out of Pocket $7,900
Plan BlueEssentials HD Gold 3 Deductible $3,000 Coinsurance Not applicable Out of Pocket $3,000
Plan BlueEssentials Silver 7 Deductible $6,400 Coinsurance Not applicable Out of Pocket $7,150
Plan BlueEssentials Gold 4 Deductible $2,700 Coinsurance Not applicable Out of Pocket $6,000
Plan BlueEssentials Silver 29 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan BlueEssentials Silver 9 Deductible $5,000 Coinsurance Not applicable Out of Pocket $6,850
Plan BlueEssentials Silver 14 Deductible $6,650 Coinsurance Not applicable Out of Pocket $7,150
Plan BlueEssentials HD Silver 6 Deductible $4,300 Coinsurance Not applicable Out of Pocket $4,300
Plan BlueEssentials HD Bronze 2 Deductible $6,300 Coinsurance Not applicable Out of Pocket $6,750
Plan BlueEssentials Catastrophic 1 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan BlueEssentials Gold 1 Deductible $2,000 Coinsurance Not applicable Out of Pocket $4,500
Plan BlueEssentials Gold 2 Deductible $1,500 Coinsurance Not applicable Out of Pocket $5,000
Plan BlueEssentials HD Silver 5 Deductible $3,300 Coinsurance Not applicable Out of Pocket $5,000
Plan BlueEssentials HD Silver 13 Deductible $4,550 Coinsurance Not applicable Out of Pocket $4,550
Plan BlueEssentials Silver 30 Deductible $6,900 Coinsurance Not applicable Out of Pocket $7,900