Bronze HMO Plans
Our Rating: 
The Blue Advantage HMO Plan 006 is the least expensive HMO plan, but also includes comprehensive benefits. Bronze Plans have a lower monthly premium and often higher out-of-pocket costs than Platinum, Gold, and Silver plans. This is an HMO plan. You must select a Blue Advantage HMO Network Primary Care Physician (PCP) when enrolling in this plan.
There are 2 BCBSTX Blue Advantage HMO Plan Options:
- Blue Advantage Bronze HMO 005 – $5,000 deductible and 80% coinsurance
- Blue Advantage Bronze HMO 006 – $6,000 deductible and 100% coinsurance
HMO Network
The The Blue Advantage Bronze HMO Plans uses the Blue Advantage HMO network, one the largest HMO networks in Minnesota. You must select a network primary care physician (PCP), who coordinates your care within the network and referrals are required from your PCP to see a specialists.
To find a BCBSTX Blue Advantage HMO Provider, use the Provider Finder and choose “Blue Advantage HMO” under Network.
Key Bronze HMO ® Plan features include:
- Lower out-of-pocket costs than PPO plans
- You must select a netowrk primary care physician (PCP), who coordinates your care within the network
- Referral required to see a specialist
- Reduced doctor visit payments for using Blue Advantage HMO Network primary care physicans (PCPs) and specialists
- Prescription drug coverage
- Maternity Coverage
- Well-adult care
- Well-child care
- Diagnostic testing
- Hospital services
- Access to the BlueCard PPO network when traveling out-of-state
- Optional dental coverage
Blue Advantage Bronze® HMO Plans may be right for you if you are an individual or family who:
- Are willing to have a primary care physican (PCP) coordinate your care
- Would like the lowest cost plan to protect yourself against major accidents and want to keep your insurance costs down
- Are in generally good health and not expecting to have surgery or major services in the near future
Learn more about valuable member services and features you get when you join the Blue Cross and Blue Shield of Minnesota family.
Blue Advantage Bronze HMO Plan Costs
Health insurance costs include monthly premium payments, individual/family deductibles, out-of-pocket expenses, copayments, and coinsurance. Here is what you can expect with Bronze® plans:
- High deductible that must be met before the insurance begins paying, except for preventive visits and birth control medications
- NO office visit copayments, all doctor visits costs count towards the deductible
- Coinsurance prescription drug benefit AFTER deductible is met
- Coinsurance of 80% with Bronze HMO 005
- Coinsurance of 100% with Bronze HMO 006
- Annual out-of-pocket maximum of $6,250 for individuals and $12,700 for families with Bronze HMO 005
- Annual out-of-pocket maximum of $6,000 for individuals and $12,700 for families with Bronze HMO 006
You must use a contracting BCBS HMO hospital, doctor or specialist for covered services. If you see a doctor or hospital that is not in the HMO netowrk, you will be responsible for all costs with the exception of hospital emergencies.
What’s Included with Blue Advantage Bronze HMO Plans®
- Preventive Care Covered at 100%, no deductible
- Coverage for major hospital, medical and surgical expenses incurred as a result of a covered accident or sickness
- Coverage for daily hospital room and board, miscellaneous hospital services, surgical services, anesthesia services, in-hospital medical services, and out-of-hospital care
- Maternity Coverage
- Prescription Drug Coverage (after deductible)
Prescription Drug Coverage
Blue Advantage Bronze HMO Plans Prescription Drug Coverage
For the Bronze HMO Plan, there is a prescription drug card benefit that includes a coinsurance after your deductible. This benefit is not immediately available and subject to the deductible.
There is a also a Home Delivery prescription benefit available with these 3 deductible options where you can receive a 90 day supply in the mail for the cost of a 60 day supply and is subject to a maximum cost of $300 per prescription.
| Outpatient Prescription Drug Benefit | Blue Advantage Bronze HMO Plan 005 | Blue Advantage Bronze HMO Plan 006 |
| Preferred Generics | 90% coinsurance after deductible | 100% coinsurance after deductible |
| Preferred Brand | 80% coinsurance after deductible | 100% coinsurance after deductible |
| Non-Preferred Formulary | 70% coinsurance after deductible | 100% coinsurance after deductible |
| Specialty | 60% coinsurance after deductible | 100% coinsurance after deductible |
Blue Advantage Bronze HMO 005
Our Rating:
| Benefit Highlight | Blue Advantage Bronze HMO 005 |
|---|---|
| Plan Features | |
| Lifetime Maximum | Unlimited |
| Participating providers | Blue Advantage HMO Network You must select a network primary care physician |
| Individual Deductible | $5,000 |
| Family Deductible | $12,700 |
| Coinsurance | 80% |
| Out of Pocket Maximum Includes deductible |
$6,250 |
| Family Out of Pocket Maximum Includes deductible |
$12,700 |
| Office Visit Copay (Primary Care/Specialist) | 80% coinsurance after deductible |
| Medical Coverage Details | |
| Outpatient Physician Medical Services Services received from a hospital or other specified provider as an outpatient |
80% coinsurance after deductible |
| Outpatient Physician Surgial Services | 80% coinsurance after deductible |
| Inpatient Hospital Medical / Surgical Services Hospital Services and Hospital Diagnostic Testing |
80% coinsurance after deductible |
| Outpatient Hospital Surgery | 80% coinsurance after deductible |
| Emergency Room / Outpatient Emergency Care Physician and Hospital |
80% coinsurance after deductible |
| Outpatient Hospital Diagnostic Testing | 80% coinsurance after deductible |
| Mental Illness & Substance Abuse Rehab (Outpatient Hospital/ Physician Care) |
80% coinsurance after deductible |
| Mental Illness & Substance Abuse Treatment (Inpatient Hospital Care) |
80% coinsurance after deductible |
| Mental Illness & Substance Abuse Treatment (Inpatient Physician Care) |
80% coinsurance after deductible |
| Preventive Care | Covered at 100%, no copay |
| Maternity Coverage | 80% coinsurance after deductible |
| Prescription Drugs | |
| Preferred Generics | 90% coinsurance after deductible |
| Preferred Brand | 80% coinsurance after deductible |
| Non-Preferred Formulary | 70% coinsurance after deductible |
| Specialty | 60% coinsurance after deductible |
| Prescription Drug Formulary | Standard |
| Cost Reductions | |
| Tax Credit Eligible | Yes |
| Cost Sharing Eligible | No |
| HSA Eligibile | No |
Outline of Coverage  |
|
Blue Advantage Bronze HMO 006
Our Rating:
| Benefit Highlight | Blue Advantage Bronze HMO 006 |
|---|---|
| Plan Features | |
| Lifetime Maximum | Unlimited |
| Participating providers | Blue Advantage HMO Network You must select a network primary care physician |
| Individual Deductible | $6,000 |
| Family Deductible | $12,700 |
| Coinsurance | 100% |
| Out of Pocket Maximum Includes deductible |
$6,000 |
| Family Out of Pocket Maximum Includes deductible |
$12,700 |
| Office Visit Copay (Primary Care/Specialist) | 100% coinsurance after deductible |
| Medical Coverage Details | |
| Outpatient Physician Medical Services Services received from a hospital or other specified provider as an outpatient |
100% coinsurance after deductible |
| Outpatient Physician Surgial Services | 100% coinsurance after deductible |
| Inpatient Hospital Medical / Surgical Services Hospital Services and Hospital Diagnostic Testing |
100% coinsurance after deductible |
| Outpatient Hospital Surgery | 100% coinsurance after deductible |
| Emergency Room / Outpatient Emergency Care Physician and Hospital |
100% coinsurance after deductible |
| Outpatient Hospital Diagnostic Testing | 100% coinsurance after deductible |
| Mental Illness & Substance Abuse Rehab (Outpatient Hospital/ Physician Care) |
100% coinsurance after deductible |
| Mental Illness & Substance Abuse Treatment (Inpatient Hospital Care) |
100% coinsurance after deductible |
| Mental Illness & Substance Abuse Treatment (Inpatient Physician Care) |
100% coinsurance after deductible |
| Preventive Care | Covered at 100%, no copay or deductible |
| Maternity Coverage | 100% coinsurance after deductible |
| Prescription Drugs | |
| Preferred Generics | 100% coinsurance after deductible |
| Preferred Brand | 100% coinsurance after deductible |
| Non-Preferred Formulary | 100% coinsurance after deductible |
| Specialty | 100% coinsurance after deductible |
| Prescription Drug Formulary | Standard |
| Cost Reductions | |
| Tax Credit Eligible | Yes |
| Cost Sharing Eligible | No |
| HSA Eligibile | No |
| Outline of Coverage |
|