Blue - Blue Advantage Silver HMO? 205 - Two $25 PCP Visits

Texas, 2019

  • Plan Type

    HMO

  • Metal Tier

    Silver

  • Out of Pocket Maximum

    $7,900

  • Deductible

    $1,900

Enroll Now
{"state":{"code":"TX","name":"Texas","fips":48,"exchangeName":["Healthcare.gov"],"exchangeUrl":["http:\/\/www.healthcare.gov"],"exchangeType":["Federal"]},"year":"2019","plan":{"name":"Blue - Blue Advantage Silver HMO? 205 - Two $25 PCP Visits","planType":"HMO","tier":"Silver","oopm":"7900.00","deductible":"1900.00","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) $1,900
Deductible (Family) $5,700
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,900
Out of Pocket Maximum (Family) $15,800

Doctor Visits

Primary Care Visit 50% 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 $950 Copay after deductible + 50% Coinsurance after deductible

Tests and Imaging

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

Prescription Drugs

Generic Rx Data Not Available
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) $1,000
Deductible (Family) $3,000
Out of Pocket Maximum (Individual) $6,300
Out of Pocket Maximum (Family) $12,600

Doctor Visits

Primary Care Physician 50% Coinsurance after deductible
Specialists 50% Coinsurance after deductible
Emergency Room $950 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
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) $75
Deductible (Family) $225
Out of Pocket Maximum (Individual) $2,600
Out of Pocket Maximum (Family) $5,200

Doctor Visits

Primary Care Physician 40% Coinsurance after deductible
Specialists 40% Coinsurance after deductible
Emergency Room $500 Copay after deductible + 40% Coinsurance after deductible
Inpatient Facility $250 Copay per stay after deductible + 40% Coinsurance after deductible
Inpatient Physician 40% Coinsurance after deductible

Prescription Drugs

Generic Rx No charge
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) $50
Deductible (Family) $150
Out of Pocket Maximum (Individual) $900
Out of Pocket Maximum (Family) $2,700

Doctor Visits

Primary Care Physician 30% 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 No charge
Preferred Brand Rx 30% Coinsurance after deductible
Non Preferred Brand Rx 35% Coinsurance after deductible
Specialty Drugs 45% Coinsurance after deductible

Other Plans in Texas

Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 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) $1,900
Deductible (Family) $5,700
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,900
Out of Pocket Maximum (Family) $15,800

Doctor Visits

Primary Care Visit 50% 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 $950 Copay after deductible + 50% Coinsurance after deductible

Tests and Imaging

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

Prescription Drugs

Generic Rx Data Not Available
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) $1,000
Deductible (Family) $3,000
Out of Pocket Maximum (Individual) $6,300
Out of Pocket Maximum (Family) $12,600

Doctor Visits

Primary Care Physician 50% Coinsurance after deductible
Specialists 50% Coinsurance after deductible
Emergency Room $950 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
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) $75
Deductible (Family) $225
Out of Pocket Maximum (Individual) $2,600
Out of Pocket Maximum (Family) $5,200

Doctor Visits

Primary Care Physician 40% Coinsurance after deductible
Specialists 40% Coinsurance after deductible
Emergency Room $500 Copay after deductible + 40% Coinsurance after deductible
Inpatient Facility $250 Copay per stay after deductible + 40% Coinsurance after deductible
Inpatient Physician 40% Coinsurance after deductible

Prescription Drugs

Generic Rx No charge
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) $50
Deductible (Family) $150
Out of Pocket Maximum (Individual) $900
Out of Pocket Maximum (Family) $2,700

Doctor Visits

Primary Care Physician 30% 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 No charge
Preferred Brand Rx 30% Coinsurance after deductible
Non Preferred Brand Rx 35% Coinsurance after deductible
Specialty Drugs 45% Coinsurance after deductible

Other Plans in Texas

Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Silver HMO? 205 - Two $25 PCP Visits Deductible $1,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 301 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Silver? 202 Deductible $1,100 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 303 Deductible $3,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Gold HMO? 206 - Three $30 PCP Visits Deductible $350 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Bronze? 305 Deductible $5,000 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Security HMO? 200 Deductible $7,900 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Plus Gold? 203 Deductible $750 Coinsurance Not applicable Out of Pocket $7,900
Plan Blue Advantage Bronze HMO? 204 - Two $40 PCP Visits Deductible $6,000 Coinsurance Not applicable Out of Pocket $7,900