2019 BlueEssentials Catastrophic 1 Plan Details - HealthPocket

BlueEssentials Catastrophic 1

$240.31/mo

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Zip Code29223
Applicant5/22/1984 Male
Coverage Start5/23/2019
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameBlueEssentials Catastrophic 1
Plan IDhhs-26065SC0390001
Plan Year2019
Insurance ProviderBlueCross BlueShield of South Carolina
Metal LevelCatastrophic
Plan TypeEPO
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$25 Copay, 0.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Specialist Visit0.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services0.00% Coinsurance after deductible
X-rays and Diagnostic Imaging0.00% Coinsurance after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans0.00% Coinsurance after deductible
Deductible - Family$15800 per group
Out-of-Pocket Maximum - Family$15800 per group

Prescription drug coverage

Generic Drugs0.00% Coinsurance after deductible
Preferred Brand Drugs0.00% Coinsurance after deductible
Non-Preferred Brand Drugs0.00% Coinsurance after deductible
Specialty Drugs0.00% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttps://www.southcarolinablues.com/links/metallic/providers/EPO
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?Not Covered
Does this plan cover services outside plan service area?No - Benefits are available only for emergency medical conditions when treated in an outpatient hospital emergency room or urgent treatment center, or for urgent conditions when treated in an urgent treatment center. Special pricing may be available through a BlueCard provider.
Does this plan cover services outside the country?No - Benefits are available only for emergency medical conditions. Special pricing may be available through a Blue Cross Blue Shield Global Core provider.

Hospital services

Emergency Room Services0.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)0.00% Coinsurance after deductible
Inpatient Physician and Surgical Services0.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service0.00% 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 Services0.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services0.00% Coinsurance after deductible
Substance use disorder outpatient services0.00% Coinsurance after deductible
Substance use disorder inpatient services0.00% Coinsurance after deductible

Medical Management Programs

Does this plan offer disease managment programs?Depression
Does this plan offer a wellness program?Not Covered

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 CareNot Covered
Child Dental Coverage - Basic Dental CareNot Covered
Child Dental Coverage - OrthodontiaNot Covered
Child Dental Coverage - Major Dental CareNot Covered

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
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
Durable Medical Equipment
Non-Emergency Care When Traveling Outside the U.S.
Diabetes Care Management
Accidental Dental
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Transplant
Well Baby Visits and Care
Breast Reconstructive Surgery
Congenital Anomaly, including Cleft Lip/Palate
Off Label Prescription Drugs
Eye Glasses for Adults
More Limited BenefitsSkilled Nursing Facility
Home Health Care Services
Outpatient Rehabilitation Services
Habilitation Services
Hospice Services
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
More Excluded BenefitsAcupuncture
Bariatric Surgery
Cosmetic Surgery
Hearing Aids
Infertility Treatment
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Weight Loss Programs
Dental Check-Up for Children
Chiropractic Care
Routine Foot Care
Abortion for Which Public Funding is Prohibited
Treatment for Temporomandibular Joint Disorders
PremiumPlan NameDeductible
from $221
BlueEssentials Catastrophic 1
$7,900.00Select
from $241
Blue Option Catastrophic
$7,900.00Select
from $338
Blue Option Bronze 7900
$7,900.00Select
from $372
Blue Option Bronze 7901
$7,900.00Select
from $374
Ambetter Essential Care 1 (2019)
$7,900.00Select
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  • Phone Number
    (803) 736-5540
  • Office Locations
    9600 Two Notch Rd
    Columbia, SC 29223
9600 Two Notch Rd Columbia SC, 29223
  • 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.

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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)