my Direct Blue Major Events EPO 8150 - 3 Free PCP Visits Plan Details for 2021- HealthPocket
Close ×

my Direct Blue Major Events EPO 8150 - 3 Free PCP Visits

$226.61/mo
View BrochureProduct BenefitsProvider DirectoryList of Covered Drugs

Apply For This Plan

Zip Code19120
Applicant1/19/1986 Male

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan Namemy Direct Blue Major Events EPO 8150 - 3 Free PCP Visits
Plan IDqhp-33709PA1040001
Plan Year2020
Insurance ProviderHighmark
Metal LevelCatastrophic
Plan TypeEPO
Deductible$8,150
Out-of-Pocket Maximum$8,150
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or IllnessNo Charge after Deductible
Specialist VisitNo Charge after Deductible
Laboratory Outpatient and Professional ServicesNo Charge after deductible
X-rays and Diagnostic ImagingNo Charge after deductible
Deductible - Family$16300
Out-of-Pocket Maximum - Family$16300

Prescription drug coverage

Generic DrugsNo Charge after Deductible
Preferred Brand DrugsNo Charge after Deductible
Non-Preferred Brand DrugsNo Charge after Deductible
Specialty DrugsNo Charge after Deductible

Access to doctors and hospitals

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

Hospital services

Emergency Room ServicesNo Charge after Deductible
Inpatient Hospital Services (e.g., Hospital Stay)No Charge after Deductible
Inpatient Physician and Surgical ServicesNo Charge after Deductible

Maternity

Prenatal and Postnatal CareNo Charge after deductible

Mental Health

Mental/Behavioral Health Outpatient ServicesNo Charge after deductible
Mental/Behavioral Health Inpatient ServicesNo Charge after deductible

Vision Coverage

Routine Eye Exam for ChildrenNo Charge after deductible
Eye Glasses for ChildrenNo Charge after deductible

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
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
Durable Medical Equipment
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Dental Check-Up for Children
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 BenefitsLong-Term/Custodial Nursing Home Care
Private-Duty Nursing
Bariatric Surgery
Cosmetic Surgery
Hearing Aids
Routine Foot Care
Acupuncture
Weight Loss Programs
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $309Ambetter Essential Care 1 (2021)$8,300.00Select
from $328Ambetter Essential Care 1 (2021) + Vision + Adult Dental$8,300.00Select
/
Please select the correct zip
Kenneth, Nguyen
View All Details
Ronald, Small
View All Details
Julie, Massey
View All Details
Loganathan, Parthipan
View All Details
Boris, Itskov
View All Details
Holy Redeemer Family Health Center
View All Details
Andre, Wallace
View All Details
Alan, Duong
View All Details
Complete Wellness Rehabilitation, Llc
View All Details
David, Ross
View All Details
Dedicated Pennsylvania Holding, Llc
View All Details
Einstein Pediatrics Associates Specialists
View All Details
Einstein Community Health Associates, Inc.
View All Details
Einstein Community Health Associates, Inc
View All Details
Einstein Community Health Associates, Inc
View All Details
Indira, Martinez
View All Details
Vip Healthcare Group
View All Details
Kenneth Nguyen, M.D.
View All Details
  • Phone Number
    (215) 324-2180
  • Office Locations
    448 E Wyoming Ave
    Philadelphia, PA 19120
448 E Wyoming Ave Philadelphia PA, 19120

  • What is the Catastrophic Plan?

    Catastrophic health insurance is a type of medical coverage under the Affordable Care Act. This is a type of high-deductible health plan for people under 30 or those who qualify for a "hardship exemption."

  • How are Catastrophic 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. There is no actuarial value associated with catastrophic plans but other Obamacare metal plans pay a higher percentage of these costs.

  • How much does a Catastrophic Plan cost?

    The monthly premium for a Catastrophic 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 Catastrophic Plan premiums in your area.

Read More

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 Benefytt Technologies, Inc. family of companies.

Health Plans Found

 

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 Benefytt Technologies, Inc. family of companies.