BlueEssentials HD Bronze 2 Plan Details for 2020- HealthPocket

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Zip Code29223
Applicant1/28/1985 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameBlueEssentials HD Bronze 2
Plan IDqhp-26065SC0380006
Plan Year2020
Insurance ProviderBlueCross BlueShield of South Carolina
Metal LevelExpanded Bronze
Plan TypeEPO
Deductible$6,300
Out-of-Pocket Maximum$6,750
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness50% Coinsurance after deductible
Specialist Visit50% Coinsurance after deductible
Laboratory Outpatient and Professional Services50.00% Coinsurance after deductible
X-rays and Diagnostic Imaging50.00% Coinsurance after deductible
Deductible - Family$12600
Out-of-Pocket Maximum - Family$13500

Prescription drug coverage

Generic Drugs50% Coinsurance after deductible
Preferred Brand Drugs50% Coinsurance after deductible
Non-Preferred Brand Drugs50% Coinsurance after deductible
Specialty Drugs50% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttps://www.southcarolinablues.com/links/providers/EPO

Hospital services

Emergency Room Services50% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)50% Coinsurance after deductible
Inpatient Physician and Surgical Services50% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care50.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services50.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services50.00% Coinsurance after deductible

Vision Coverage

Routine Eye Exam for ChildrenNot Applicable
Eye Glasses for ChildrenNot Applicable

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
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Durable Medical Equipment
Rehabilitative Speech Therapy
Rehabilitative Occupational and Rehabilitative Physical Therapy
Well Baby Visits and Care
Transplant
Accidental Dental
Dialysis
Allergy Testing
Chemotherapy
Radiation
Diabetes Education
Prosthetic Devices
Infusion Therapy
Nutritional Counseling
Reconstructive Surgery
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
More Excluded BenefitsInfertility Treatment
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Bariatric Surgery
Cosmetic Surgery
Chiropractic Care
Hearing Aids
Abortion for Which Public Funding is Prohibited
Treatment for Temporomandibular Joint Disorders
Routine Foot Care
Acupuncture
Weight Loss Programs
Dental Check-Up for Children
PremiumPlan NameDeductible
from $300
BlueEssentials Bronze 4
$6,400.00Select
from $328
Constant Care Silver 2
$6,500.00Select
from $331
Bronze Premier 1
$6,100.00Select
from $365
Blue Option Bronze 6500
$6,500.00Select
from $380
Ambetter Balanced Care 12 (2020)
$6,500.00Select
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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

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family 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 part of the Health Insurance Innovations, Inc. family of companies (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, or an individual and family 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 part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).