Blue Advantage Silver HMO 306 Plan Details for 2020- HealthPocket

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Zip Code	79936 (edit)
Applicant	4/6/1985 Male (edit)

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Insurance Type	ACA (Obamacare)
Plan Name	Blue Advantage Silver HMO 306
Plan ID	hhs-33602TX0460758
Plan Year	2020
Insurance Provider	BlueCross BlueShield of Texas
Metal Level	Silver
Plan Type	HMO
Deductible	$2,000
Out-of-Pocket Maximum	$8,150
Plan Highlights

Costs for Medical Care
Primary Care Visit to Treat an Injury or Illness	$25 Copay
Specialist Visit	50.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	40.00% Coinsurance after deductible
X-rays and Diagnostic Imaging	40.00% Coinsurance after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans	40.00% Coinsurance after deductible
Deductible - Family	$5700 per group
Out-of-Pocket Maximum - Family	$16300 per group

Prescription drug coverage
Generic Drugs	$5 Copay
Preferred Brand Drugs	30.00% Coinsurance after deductible
Non-Preferred Brand Drugs	35.00% Coinsurance after deductible
Specialty Drugs	45.00% Coinsurance after deductible

Access to doctors and hospitals
Provider directory URL	http://www.bcbstx.com/onlinedirectory/index.htm
Does this plan have access to a national provider network?	No
Is a referral required to see a Specialist?	Yes - Referrals are required for some services. Please check with your Medical Group for details.
Does this plan cover services outside plan service area?	Yes - Coverage outside our service area is available for Emergency and Urgent Care services only.
Does this plan cover services outside the country?	Yes - No coverage for any services, supplies or drugs received by a Member outside of the United States, except for Emergency Care.

Hospital services
Emergency Room Services	$950 Copay with deductible, 50.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Inpatient Hospital Services (e.g., Hospital Stay)	$850 Copay per Stay with deductible, 50.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Inpatient Physician and Surgical Services	50.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service	50.00% Coinsurance after deductible

Maternity
Prenatal and Postnatal Care	$25 Copay
Delivery and all inpatient services for maternity care	$850 Copay with deductible, 50.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.

Mental Health
Mental/Behavioral Health Outpatient Services	50.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services	$850 Copay per Stay with deductible, 50.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Substance use disorder outpatient services	50.00% Coinsurance after deductible
Substance use disorder inpatient services	$850 Copay per Stay with deductible, 50.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.

Medical Management Programs
Does this plan offer disease managment programs?	Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy
Does this plan offer a wellness program?	Not Covered

Vision Coverage
Routine Eye Exam for Children	Included
Eye Glasses for Children	Included
Routine Eye Exam for Adults	Not Covered

Child Dental Coverage
Child Dental Coverage - Routine Dental Care	Not Covered
Child Dental Coverage - Basic Dental Care	Not Covered
Child Dental Coverage - Orthodontia	Not Covered
Child Dental Coverage - Major Dental Care	Not Covered

Adult Dental Coverage
Adult Dental Coverage - Routine Dental Care	Not Covered
Adult Dental Coverage - Basic Dental Care	Not Covered
Adult Dental Coverage - Orthodontia	Not Covered
Adult Dental Coverage - Major Dental Care	Not Covered

Exclusions and Limitations
More Included Benefits	Other Practitioner Office Visit (Nurse, Physician Assistant) Preventive Care/Screening/Immunization Imaging (CT/PET Scans, MRIs) Outpatient Surgery Physician/Surgical Services Urgent Care Centers or Facilities Inpatient Physician and Surgical Services Durable Medical Equipment Hospice Services Accidental Dental Allergy Testing Chemotherapy Diabetes Education Dialysis Infusion Therapy Laboratory Outpatient and Professional Services Prosthetic Devices Radiation Reconstructive Surgery Rehabilitative Speech Therapy Transplant Treatment for Temporomandibular Joint Disorders Well Baby Visits and Care Prescription Drugs Other Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
More Limited Benefits	Skilled Nursing Facility Hearing Aids Home Health Care Services Outpatient Rehabilitation Services Habilitation Services Chiropractic Care Rehabilitative Occupational and Rehabilitative Physical Therapy
More Excluded Benefits	Acupuncture Bariatric Surgery Cosmetic Surgery Infertility Treatment Long-Term/Custodial Nursing Home Care Private-Duty Nursing Weight Loss Programs Dental Check-Up for Children Routine Foot Care Abortion for Which Public Funding is Prohibited Nutritional Counseling

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Premium

Plan Name

Deductible

from $376

Blue Advantage Silver HMO℠ 205 - Two $25 PCP Visits

$1,900.00

Select

from $392

Blue Advantage Silver HMO 306

$2,000.00

Select

from $413

Blue Advantage Plus Silver 306

$2,000.00

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from $472

Blue Advantage Silver HMO 205 - Two $25 PCP Visits

$1,900.00

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from $476

IND Gold HMO 2000

$2,000.00

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Last Name

Location/Distance

Please select the correct zip

Olmer, Brooker

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Huma, Lodhi

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Patricia, Azarcon-samonte

Thomas, Hoffer

Bertha, Garcia

Bertha, Anderson

Alyson, Martinez

Dawn, Sackett

Erin, Ginithan

Saranya, Gangupalli

Elena, Paul

Jose, Ruiz

El Paso Pelvic Health Pllc

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The Foot Institute, P.a.

Stephanie, Acosta

Jose, Marquez

Eduardo, Torres

Cep America Llc

Katelyn, Vera

Larry, Felix

Lluvia, Mendiola

C Care Cardiovascular Center

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Olmer Brooker, M.D.

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Phone Number
(915) 855-7900
Office Locations
1418 George Dieter Dr
El Paso, TX 79936

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.

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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Blue Advantage Silver HMO 306

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Costs for Medical Care

Prescription drug coverage

Access to doctors and hospitals

Hospital services

Maternity

Mental Health

Medical Management Programs

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