my Direct Blue EPO Bronze 7800 - 1 Free PCP Visit Plan Details for 2020- HealthPocket

my Direct Blue EPO Bronze 7800 - 1 Free PCP Visit

$286.39/mo

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Zip Code19120
Applicant4/6/1985 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan Namemy Direct Blue EPO Bronze 7800 - 1 Free PCP Visit
Plan IDqhp-33709PA0870011
Plan Year2020
Insurance ProviderHighmark
Metal LevelExpanded Bronze
Plan TypeEPO
Deductible$7,800
Out-of-Pocket Maximum$7,900
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness40% Coinsurance after deductible
Specialist Visit40% Coinsurance after deductible
Laboratory Outpatient and Professional Services40.00% Coinsurance after deductible
X-rays and Diagnostic Imaging40.00% Coinsurance after deductible
Deductible - Family$15600
Out-of-Pocket Maximum - Family$15800

Prescription drug coverage

Generic DrugsNo Charge
Preferred Brand Drugs$20 Copay
Non-Preferred Brand Drugs35% Coinsurance after deductible
Specialty Drugs50% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttps://www.highmarkbcbs.com/find-a-doctor/#/home

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 Care40.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services40.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services40.00% Coinsurance after deductible

Vision Coverage

Routine Eye Exam for Children0.00%
Eye Glasses for Children0.00%

Exclusions and Limitations

More Included BenefitsDurable Medical Equipment
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Dental Check-Up for Children
Other Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Infertility Treatment
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
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
Nutritional Counseling
Reconstructive Surgery
Diabetes Care Management
Inherited Metabolic Disorder - PKU
Dental Anesthesia
More Excluded BenefitsHearing Aids
Routine Foot Care
Acupuncture
Weight Loss Programs
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Bariatric Surgery
Cosmetic Surgery
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $186
Together Blue EPO Bronze 7900
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Together Blue EPO Bronze 7800 - 1 Free PCP Visit
$7,800.00Select
from $200
my Direct Blue Erie HMO Bronze 7900
$7,900.00Select
from $212
my Direct Blue Erie HMO Bronze 7800 - 1 Free PCP Visit
$7,800.00Select
from $228
Together Blue EPO Bronze 7900
$7,900.00Select
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  • Phone Number
    (215) 324-2180
  • Office Locations
    448 E Wyoming Ave
    Philadelphia, PA 19120
448 E Wyoming Ave Philadelphia PA, 19120

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HealthPocket.com provides information on insurance products. If you choose to obtain a quote or apply for an insurance plan, you may be transferred to a partner website to complete your request. Always review the privacy and terms of use of the partner website.

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).