Blue Advantage Plus Bronze℠ 303 Plan Details for 2020- HealthPocket

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Zip Code79936
Applicant12/14/1984 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameBlue Advantage Plus Bronze℠ 303
Plan IDqhp-33602TX0770209
Plan Year2020
Insurance ProviderBlueCross BlueShield of Texas
Metal LevelExpanded Bronze
Plan TypeHMO
Deductible$3,900
Out-of-Pocket Maximum$8,150
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$40 Copay
Specialist Visit40% Coinsurance after deductible
Laboratory Outpatient and Professional Services30.00% Coinsurance after deductible
X-rays and Diagnostic Imaging30.00% Coinsurance after deductible
Deductible - Family$11700
Out-of-Pocket Maximum - Family$16300

Prescription drug coverage

Generic Drugs$10 Copay
Preferred Brand Drugs30% Coinsurance after deductible
Non-Preferred Brand Drugs35% Coinsurance after deductible
Specialty Drugs45% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttps://public.hcsc.net/providerfinder/search.do?corpEntCd=TX1&residencestate=TX&product=BAV&entryPt=MKT

Hospital services

Emergency Room Services40% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)40% Coinsurance after deductible
Inpatient Physician and Surgical Services40% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care0.00%

Mental Health

Mental/Behavioral Health Outpatient Services0.00%
Mental/Behavioral Health Inpatient Services0.00%

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
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Skilled Nursing Facility
Hospice Services
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Durable Medical Equipment
Hearing Aids
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
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
Treatment for Temporomandibular Joint Disorders
Reconstructive Surgery
Prescription Drugs Other
More Excluded BenefitsInfertility Treatment
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Bariatric Surgery
Cosmetic Surgery
Routine Foot Care
Acupuncture
Weight Loss Programs
Dental Check-Up for Children
Abortion for Which Public Funding is Prohibited
Nutritional Counseling
PremiumPlan NameDeductible
from $329
Blue Advantage Plus Bronze℠ 303
$3,900.00Select
from $398
CHP TX Silver LD - Two Free PCP Visits
$3,700.00Select
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  • Phone Number
    (915) 855-7900
  • Office Locations
    1418 George Dieter Dr
    El Paso, TX 79936
1418 George Dieter Dr El Paso TX, 79936

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).