2019 Blue Value Catastrophic (limited network) Plan Details - HealthPocket

Blue Value Catastrophic (limited network)

$196.43/mo

Apply For This Plan

Zip Code28269
Applicant8/24/1984 Male
Coverage Start8/25/2019
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameBlue Value Catastrophic (limited network)
Plan IDqhp-11512NC0100031
Plan Year2019
Insurance ProviderBlue Cross Blue Shield of North Carolina
Metal LevelCatastrophic
Plan TypePOS
Deductible$7,900
Out-of-Pocket Maximum$7,900
Personal Score

Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$35 Copay
Specialist VisitNo Charge after Deductible
Laboratory Outpatient and Professional Services0.00% Coinsurance after deductible
X-rays and Diagnostic Imaging0.00% Coinsurance after deductible
Deductible - Family$15800
Out-of-Pocket Maximum - Family$15800

Prescription drug coverage

Generic DrugsNo Charge after Deductible
Preferred Brand DrugsNo Charge after Deductible
Non-Preferred Brand DrugsNo Charge after Deductible
Specialty DrugsNo Charge after Deductible

Access to doctors and hospitals

Provider directory URLComing Soon

Hospital services

Emergency Room ServicesNo Charge after Deductible
Inpatient Hospital Services (e.g., Hospital Stay)No Charge after Deductible
Inpatient Physician and Surgical ServicesNo Charge after Deductible

Maternity

Prenatal and Postnatal Care0.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services0.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services0.00% Coinsurance after deductible

Vision Coverage

Routine Eye Exam for Children0.00% Coinsurance after deductible
Eye Glasses for Children0.00% Coinsurance after deductible

Exclusions and Limitations

More Included BenefitsOther Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Infertility Treatment
Private-Duty Nursing
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Bariatric Surgery
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Durable Medical Equipment
Hearing Aids
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Chemotherapy
Routine Foot Care
Dental Check-Up for Children
Rehabilitative Speech Therapy
Rehabilitative Occupational and Rehabilitative Physical Therapy
Well Baby Visits and Care
Transplant
Accidental Dental
Dialysis
Allergy Testing
Radiation
Diabetes Education
Infusion Therapy
Treatment for Temporomandibular Joint Disorders
Nutritional Counseling
Reconstructive Surgery
Non-Emergency Care When Traveling Outside of the U.S.
Dental Anesthesia
Diabetes Care Management
Clinical Trials
Congenital Anomaly, including Cleft Lip/Palate
Tier 2 Rx
Tier 6 Rx
Prenatal and Postnatal Care - Non-Global Maternity
More Excluded BenefitsLong-Term/Custodial Nursing Home Care
Cosmetic Surgery
Acupuncture
Weight Loss Programs
Abortion for Which Public Funding is Prohibited
Prosthetic Devices
Off-label Prescription Drugs
PremiumPlan NameDeductible
from $160
Blue Value Catastrophic (limited network with UNC Health Alliance)
$7,900.00Select
from $196
Blue Value Catastrophic (limited network with UNC Health Allian
$7,900.00Select
from $204
Blue Local Catastrophic (local network with Atrium Health)
$7,900.00Select
from $240
Blue Advantage Catastrophic (broad network)
$7,900.00Select
from $250
Blue Local Catastrophic (local network with Atrium Health)
$7,900.00Select
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  • Phone Number
    (704) 921-6659
  • Office Locations
    10616 Metromont Pkwy
    Charlotte, NC 28269
10616 Metromont Pkwy Charlotte NC, 28269
  • What is the Catastrophic Plan?

    Catastrophic health insurance is a type of medical coverage under the Affordable Care Act. This is a type of high-deductible health plan for people under 30 or those who qualify for a "hardship exemption."

  • How are Catastrophic 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. There is no actuarial value associated with catastrophic plans but other Obamacare metal plans pay a higher percentage of these costs.

  • How much does a Catastrophic Plan cost?

    The monthly premium for a Catastrophic 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 Catastrophic Plan premiums in your area.

Read More

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)