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?
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