2019 Blue Value Silver Plan Details - HealthPocket

Blue Value Silver

$513.67/mo

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Zip Code35215
Applicant7/24/1984 Male
Coverage Start7/25/2019
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameBlue Value Silver
Plan IDhhs-46944AL0410001
Plan Year2019
Insurance ProviderBlue Cross Blue Shield of Alabama
Metal LevelSilver
Plan TypePPO
Deductible$2,600
Out-of-Pocket Maximum$7,900
Personal Score

Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$40 Copay
Specialist Visit$55 Copay
Laboratory Outpatient and Professional ServicesNo Charge
X-rays and Diagnostic ImagingNo Charge
Diagnostic Imaging such as MRIs, CT, and PET scans$400 Copay
Deductible - Family$5200 per group
Out-of-Pocket Maximum - Family$15800 per group

Prescription drug coverage

Generic Drugs$20 Copay
Preferred Brand Drugs$85 Copay
Non-Preferred Brand Drugs50.00% Coinsurance
Specialty Drugs$250 Copay

Access to doctors and hospitals

Provider directory URLhttps://www.bcbsal.org/web/provider-finder
Does this plan have access to a national provider network?Yes
Is a referral required to see a Specialist?Not Covered
Does this plan cover services outside plan service area?Yes - If a PPO provider is used, same benefits as PPO in service area apply. If non-PPO provider is used, member may be responsible for filing claims and out-of-network benefits would be applicable.
Does this plan cover services outside the country?Yes - If a PPO provider is used, same benefits as PPO in country apply. If non-PPO provider is used, member is responsible for filing claims and out-of-network benefits would be applicable.

Hospital services

Emergency Room Services$400 Copay
Inpatient Hospital Services (e.g., Hospital Stay)20.00% Coinsurance
Inpatient Physician and Surgical Services0.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service20.00% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care0.00% Coinsurance after deductible
Delivery and all inpatient services for maternity care0.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services$55 Copay
Mental/Behavioral Health Inpatient ServicesNo Charge
Substance use disorder outpatient services$55 Copay
Substance use disorder inpatient servicesNo Charge

Medical Management Programs

Does this plan offer disease managment programs?Asthma, Diabetes, Heart Disease, Pregnancy
Does this plan offer a wellness program?Included

Vision Coverage

Routine Eye Exam for ChildrenIncluded
Eye Glasses for ChildrenIncluded
Routine Eye Exam for AdultsNot Covered

Child Dental Coverage

Child Dental Coverage - Routine Dental CareIncluded
Child Dental Coverage - Basic Dental CareIncluded
Child Dental Coverage - OrthodontiaIncluded
Child Dental Coverage - Major Dental CareIncluded

Adult Dental Coverage

Adult Dental Coverage - Routine Dental CareNot Covered
Adult Dental Coverage - Basic Dental CareNot Covered
Adult Dental Coverage - OrthodontiaNot Covered
Adult Dental Coverage - Major Dental CareNot Covered

Exclusions and Limitations

More Included BenefitsOther Practitioner Office Visit (Nurse, Physician Assistant)
Preventive Care/Screening/Immunization
Infertility Treatment
Imaging (CT/PET Scans, MRIs)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Home Health Care Services
Durable Medical Equipment
Hospice Services
Non-Emergency Care When Traveling Outside the U.S.
Accidental Dental
Allergy Testing
Chemotherapy
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Prosthetic Devices
Radiation
Reconstructive Surgery
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Off Label Prescription Drugs
Telephone and Online Video Physician Consultation
More Limited BenefitsOutpatient Rehabilitation Services
Habilitation Services
Dental Check-Up for Children
Chiropractic Care
Diabetes Education
Nutritional Counseling
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
Air Ambulance
More Excluded BenefitsSkilled Nursing Facility
Acupuncture
Bariatric Surgery
Cosmetic Surgery
Hearing Aids
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Weight Loss Programs
Routine Foot Care
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $225
Humana Local Preferred Gold 2500/3500 Plan
$2,500.00Select
from $227
Humana Local Preferred Gold 2500/3500 Plan
$2,500.00Select
from $386
Blue Cross Select Silver
$2,800.00Select
from $420
Blue Value Silver
$2,600.00Select
from $460
Blue Secure Silver
$2,500.00Select
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  • Phone Number
    (205) 833-6888
  • Office Locations
    9772 Parkway E
    Birmingham, AL 35215
9772 Parkway E Birmingham AL, 35215
  • What Is the Silver Plan?

    ObamaCare’s Silver Plan is a type of Metal Plan on the Health Insurance Marketplace. Silver Plans qualify for both Tax Credits and Cost Sharing subsidies.Silver Plans have lower out-of-pocket costs than Bronze Plans but higher out- of-pocket costs than both Gold and Platinum Plans. All Silver Plans share the same minimum health benefits, but the way they charge out-of-pocket costs can differ significantly.

  • How are Silver Plans different than other Obamacare health plans?

    The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Silver Plan pays 70% of covered medical costs for a typical enrollee. Silver Plans are also the only metal plans which offer cost-sharing reduction (CSR) versions to consumers that require financial assistance for out-of-pocket costs.

  • How much does a Silver Plan cost?

    The monthly premium for a Silver Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and the region in which you live. You can use HealthPocket’s comparison tool to compare Silver Plan premiums in your area.

  • When Can I Enroll in a Silver Plan?

    The Open Enrollment period for the 2018 Affordable Care Act health plans begins November 1, 2017 and ends December 15, 2017. See our Open Enrollment article for more information.

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is a wholly owned subsidiary of Health Plan Intermediaries Holdings LLC (NASDAQ: HIIQ)

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is a wholly owned subsidiary of Health Plan Intermediaries Holdings LLC (NASDAQ: HIIQ)