BlueEssentialsPlus $2500 Silver

Individual Health Insurance (Obamacare)

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Benefits & Coverage

Plan Name
BlueEssentialsPlus $2500 Silver
Plan ID
29678NE1040001
Plan Year
2014
Insurance Type
Individual Health Insurance (Obamacare)
Metal Level
Silver
Plan Type
PPO
Deductible
$2,500
Out-of-Pocket Maximum
$6,350
Plan Highlights

Cost & Coverage

Estimated Monthly Base Rate
Estimated monthly premium starts at $341.57
Deductible
Individual: $2500
Family: $5000
In-Network Out-of-Pocket Limit
Individual: $6350
Family: $12700
What is included in the in-network out-of-pocket limit?
Deductible + Coinsurance
Is this plan Health Savings Account (HSA) eligible?
No
How can I find a doctor in this plan's network?
Plan Type
PPO

Health Services Options

Service
In Network
Out of Network
Primary care physician office visit
$30 Copay
50% Coinsurance after deductible
Specialist
$60 Copay
50% Coinsurance after deductible
Diagnostic Test (X-ray, blood work)
20% Coinsurance after deductible
50% Coinsurance after deductible
Outpatient Facility Fee
20% Coinsurance after deductible
50% Coinsurance after deductible
Outpatient Physician/Surgeon Fee
20% Coinsurance after deductible
50% Coinsurance after deductible
Hospital facility fee
20% Coinsurance after deductible
50% Coinsurance after deductible
Hospital physician/surgeon fee
20% Coinsurance after deductible
50% Coinsurance after deductible
Emergency Room
$300 Copay after deductible
$300 Copay after deductible

Drug Services

Generic Drugs
Coverage: 20% Coinsurance after deductible
Preferred Brand Drugs
Coverage: 20% Coinsurance after deductible
Specialty Drugs
Coverage: 20% Coinsurance after deductible
What drugs are covered in the formulary?

Mental Health or Substance Abuse Services

Service
In Network
Out of Network
Mental/behavioral health outpatient services
$30 Copay
50% Coinsurance after deductible
Mental/behavioral health inpatient services
20% Coinsurance after deductible
50% Coinsurance after deductible
Substance use disorder inpatient services
20% Coinsurance after deductible
50% Coinsurance after deductible
Substance use disorder outpatient services
$30 Copay
50% Coinsurance after deductible

Maternity Services

Service
In Network
Out of Network
Prenatal/postnatal care
20% Coinsurance after deductible
50% Coinsurance after deductible
Delivery and all inpatient services for maternity care
20% Coinsurance after deductible
50% Coinsurance after deductible

Coverage Options Summary

Included Benefits
  • Chiropractic
  • Dental check up children
  • Durable medical equipment
  • Emergency Transportation
  • Eye exam adult
  • Eye glasses children
  • Habilitation
  • Home health care
  • Hospice
  • Imaging (CT/PET scans, MRIs)
  • Inpatient rehabilitation
  • Non-emergency care outside U.S.
  • Non-preferred brand drugs
  • Skilled nursing care
  • Other practitioner office visit
  • Outpatient rehabilitation
  • Preventive care, screening, immunization
  • Routine eye exam children
  • Routine hearing tests
  • Urgent Care
Excluded Benefits
  • Acupuncture
  • Bariatric surgery
  • Cosmetic surgery
  • Dental care adult
  • Hearing Aid
  • Infertility treatment
  • Long Term Care
  • Private duty nursing
  • Routine foot care
  • Weight loss program

What To Know

  • This is an ACA (Obamacare) compliant health plan.
  • This plan is eligible for a tax credit subsidy

Physician Directory

List of doctors that accepts BlueEssentialsPlus $2500 Silver Obamacare Plan in Nebraska

/
FRANCO, THEODORE
5709 NW RADIAL HWY
OMAHA, NE 68104
GORDON, JOSETTE
2734 N 61ST ST
OMAHA, NE 68104
CURRAN, JODIE
6032 VILLE DE SANTE DR
OMAHA, NE 68104
PRICKETT, WESLEY
1513 N 60TH ST
OMAHA, NE 68104
JESSEN, PETER
5404 AMES AVENUE
OMAHA, NE 68104
YAO, CHYUN
16120 W DODGE RD
OMAHA, NE 68118
MILLEA, DAVID
2746 NO 63RD ST
OMAHA, NE 68104
SCHLATTMANN, MEGHAN
119 N 51ST ST
OMAHA, NE 68132
HOBERMAN, CLAYTON
702 N 58TH ST
OMAHA, NE 68132
SCHLATTMANN, BRIAN
119 N 51ST ST
OMAHA, NE 68132
SAUER, TODD
702 N 58TH ST
OMAHA, NE 68132
SPECHT, PAT
119 N 51ST ST
OMAHA, NE 68132
OETTER, MINDY
444 S 44TH ST
OMAHA, NE 68131
CANNELLA, AMY
988102 NEBRASKA MEDICAL CTR
OMAHA, NE 68198
GORDON, GREGORY
981045 NEBRASKA MEDICAL CTR
OMAHA, NE 68198
BAKER, JOHN
988102 NEBRASKA MEDICAL CTR
OMAHA, NE 68198
BUEHLER, BRUCE
988102 NEBRASKA MEDICAL CTR
OMAHA, NE 68198
BRIDGE, JULIA
988102 NEBRASKA MEDICAL CTR
OMAHA, NE 68198
BRAKKE, TARA
988102 NEBRASKA MEDICAL CTR
OMAHA, NE 68198
ANDERSON, JOSEPH
988102 NEBRASKA MEDICAL CTR
OMAHA, NE 68198
RODABAUGH, KERRY
988102 NEBRASKA MEDICAL CTR
OMAHA, NE 68198
ATTARD, THOMAS
988095 NEBRASKA MEDICAL CTR
OMAHA, NE 68198
CROSSMAN, JOY
988102 NEBRASKA MEDICAL CTR
OMAHA, NE 68198
CONNOLLY-INDA, EILEEN
988095 NEBRASKA MEDICAL CTR
OMAHA, NE 68198
BIRCH, KRISTINA
988102 NEBRASKA MEDICAL CTR
OMAHA, NE 68198
Details
THEODORE FRANCO, DDS
Phone Number
(402) 551-1757
Office Locations
5709 NW RADIAL HWY
OMAHA, NE 68104
5709 NW RADIAL HWY OMAHA NE, 68104

Community Q&A

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