Blue Cross Blue Shield Silver Plans

Blue Advantage Silver HMO 102:

Key Features:

Deductible – $3,000

Out of Pocked Max – 30%

Primary Care Provider Visits – $7,150

Specialist Office Visits – $60

Mental Illness and Substance Abuse Treatment – $40

ER Visit – $600 per occurrence copay, then 30%

Urgent Care – $40

In Patient Hospital Care – $500 per occurrence copay, then 30%

Out Patient Surgery – $300 per occurrence copay, then 50%

Out Patient X-Rays and Diagnostic Imaging – 50%

Out Patient imaging(CT/PET/MRIs) – 30%

HSA Eligible – No

Outpatient Prescription Drugs(preferred pharmacy) –

Outpatient Prescription Drugs(Non Preferred Pharmacy) –

Blue Advantage Silver HMO 103:

Key Features:

Deductible –

Out of Pocked Max –

Primary Care Provider Visits –

Specialist Office Visits –

Mental Illness and Substance Abuse Treatment –

ER Visit –

Urgent Care –

In Patient Hospital Care –

Out Patient Surgery –

Out Patient X-Rays and Diagnostic Imaging –

Out Patient imaging(CT/PET/MRIs) –

HSA Eligible –

Outpatient Prescription Drugs(preferred pharmacy) –

Outpatient Prescription Drugs(Non Preferred Pharmacy) –

Blue Advantage Silver HMO 107:

Key Features:

Deductible –

Out of Pocked Max –

Primary Care Provider Visits –

Specialist Office Visits –

Mental Illness and Substance Abuse Treatment –

ER Visit –

Urgent Care –

In Patient Hospital Care –

Out Patient Surgery –

Out Patient X-Rays and Diagnostic Imaging –

Out Patient imaging(CT/PET/MRIs) –

HSA Eligible –

Outpatient Prescription Drugs(preferred pharmacy) –

Outpatient Prescription Drugs(Non Preferred Pharmacy) –

Blue Advantage Plus Silver 102:

Key Features:

Deductible –

Out of Pocked Max –

Primary Care Provider Visits –

Specialist Office Visits –

Mental Illness and Substance Abuse Treatment –

ER Visit –

Urgent Care –

In Patient Hospital Care –

Out Patient Surgery –

Out Patient X-Rays and Diagnostic Imaging –

Out Patient imaging(CT/PET/MRIs) –

HSA Eligible –

Outpatient Prescription Drugs(preferred pharmacy) –

Outpatient Prescription Drugs(Non Preferred Pharmacy) –

Which plan is Right for me?

What are the benefits of these plans?