EverydayHealth HMO 7000 - Neighborhood Network Plan Details for 2020- HealthPocket

EverydayHealth HMO 7000 - Neighborhood Network

$405.15/mo

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Zip Code85364
Applicant12/14/1984 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameEverydayHealth HMO 7000 - Neighborhood Network
Plan IDhhs-53901AZ1420016
Plan Year2020
Insurance ProviderBlue Cross Blue Shield of Arizona
Metal LevelExpanded Bronze
Plan TypeHMO
Deductible$7,000
Out-of-Pocket Maximum$8,150
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$50 Copay
Specialist Visit$100 Copay
Laboratory Outpatient and Professional Services45.00% Coinsurance after deductible
X-rays and Diagnostic Imaging45.00% Coinsurance after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans45.00% Coinsurance after deductible
Deductible - Family$14000 per group
Out-of-Pocket Maximum - Family$16300 per group

Prescription drug coverage

Generic Drugs$35 Copay
Preferred Brand Drugs$150 Copay after deductible
Non-Preferred Brand Drugs40.00% Coinsurance after deductible
Specialty Drugs50.00% Coinsurance

Access to doctors and hospitals

Provider directory URLhttps://www.azblue.com/individualsandfamilies/find-a-doctor
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?Yes - You must select a network PCP and notify BCBSAZ of your selection. PCP referral required for all Specialists except OB/GYN, Chiropractors, Outpatient Behavioral Health providers, Telehealth and Urgent Care services and Emergency services.
Does this plan cover services outside plan service area?Yes - Emergencies and Authorized Follow-up Care
Does this plan cover services outside the country?Yes - Emergencies Only

Hospital services

Emergency Room Services45.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)45.00% Coinsurance after deductible
Inpatient Physician and Surgical Services45.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service45.00% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care$100 Copay
Delivery and all inpatient services for maternity care45.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services$100 Copay
Mental/Behavioral Health Inpatient Services45.00% Coinsurance after deductible
Substance use disorder outpatient services$100 Copay
Substance use disorder inpatient services45.00% Coinsurance after deductible

Medical Management Programs

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 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)
Bariatric Surgery
Private-Duty Nursing
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
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
More Limited BenefitsPreventive Care/Screening/Immunization
Skilled Nursing Facility
Hearing Aids
Home Health Care Services
Outpatient Rehabilitation Services
Habilitation Services
Dental Check-Up for Children
Chiropractic Care
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
More Excluded BenefitsAcupuncture
Cosmetic Surgery
Infertility Treatment
Long-Term/Custodial Nursing Home Care
Weight Loss Programs
Routine Foot Care
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $227
EverydayHealth HMO 7000 - PimaFocus Network
$7,000.00Select
from $266
Cigna Connect 7000
$7,000.00Select
from $277
EverydayHealth HMO 7000 - PimaFocus Network
$7,000.00Select
from $300
EverydayHealth HMO 7000 - MaricopaFocus Network
$7,000.00Select
from $302
Bronze HSA
$6,850.00Select
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  • Phone Number
    (602) 273-6770
  • Office Locations
    2400 S Ave A
    Yuma, AZ 85364
2400 S Ave A Yuma AZ, 85364

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).