Insurance Type | ACA (Obamacare) |
Plan Name | Blue HSA Gold |
Plan ID | hhs-46944AL0330001 |
Plan Year | 2021 |
Insurance Provider | Blue Cross Blue Shield of Alabama |
Metal Level | Gold |
Plan Type | PPO |
Deductible | $1,750 |
Out-of-Pocket Maximum | $6,000 |
Plan Highlights |
Costs for Medical Care | |
---|---|
Primary Care Visit to Treat an Injury or Illness | 10.00% Coinsurance after deductible |
Specialist Visit | 10.00% Coinsurance after deductible |
Laboratory Outpatient and Professional Services | 10.00% Coinsurance after deductible |
X-rays and Diagnostic Imaging | 10.00% Coinsurance after deductible |
Diagnostic Imaging such as MRIs, CT, and PET scans | 10.00% Coinsurance after deductible |
Deductible - Family | $3500 per group |
Out-of-Pocket Maximum - Family | $12000 per group |
Prescription drug coverage | |
---|---|
Generic Drugs | 10.00% Coinsurance after deductible |
Preferred Brand Drugs | 10.00% Coinsurance after deductible |
Non-Preferred Brand Drugs | 10.00% Coinsurance after deductible |
Specialty Drugs | 10.00% Coinsurance after deductible |
Access to doctors and hospitals | |
---|---|
Provider directory URL | https://www.bcbsal.org/web/provider-finder |
Does this plan have access to a national provider network? | Yes |
Is a referral required to see a Specialist? | Not Covered |
Does this plan cover services outside plan service area? | Yes - If a PPO provider is used, same benefits as PPO in service area apply. If non-PPO provider is used, member may be responsible for filing claims and out-of-network benefits would be applicable. |
Does this plan cover services outside the country? | Yes - If a PPO provider is used, same benefits as PPO in country apply. If non-PPO provider is used, member is responsible for filing claims and out-of-network benefits would be applicable. |
Hospital services | |
---|---|
Emergency Room Services | 10.00% Coinsurance after deductible |
Inpatient Hospital Services (e.g., Hospital Stay) | 10.00% Coinsurance after deductible |
Inpatient Physician and Surgical Services | 10.00% Coinsurance after deductible |
Emergency Transportation or Ambulance Service | 10.00% Coinsurance after deductible |
Maternity | |
---|---|
Prenatal and Postnatal Care | 10.00% Coinsurance after deductible |
Delivery and all inpatient services for maternity care | 10.00% Coinsurance after deductible |
Mental Health | |
---|---|
Mental/Behavioral Health Outpatient Services | 10.00% Coinsurance after deductible |
Mental/Behavioral Health Inpatient Services | 10.00% Coinsurance after deductible |
Substance use disorder outpatient services | 10.00% Coinsurance after deductible |
Substance use disorder inpatient services | 10.00% Coinsurance after deductible |
Medical Management Programs | |
---|---|
Does this plan offer disease managment programs? | Asthma, Diabetes, Heart Disease, Pregnancy |
Does this plan offer a wellness program? | Included |
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 | Included |
Child Dental Coverage - Basic Dental Care | Included |
Child Dental Coverage - Orthodontia | Included |
Child Dental Coverage - Major Dental Care | Included |
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 Infertility Treatment Imaging (CT/PET Scans, MRIs) Outpatient Facility Fee (e.g., Ambulatory Surgery Center) Outpatient Surgery Physician/Surgical Services Urgent Care Centers or Facilities Inpatient Physician and Surgical Services Home Health Care Services Durable Medical Equipment Hospice Services Non-Emergency Care When Traveling Outside the U.S. Accidental Dental Allergy Testing Chemotherapy Dialysis Infusion Therapy Laboratory Outpatient and Professional Services Prosthetic Devices Radiation Reconstructive Surgery Transplant Treatment for Temporomandibular Joint Disorders Well Baby Visits and Care Off Label Prescription Drugs Telephone and Online Video Physician Consultation Outpatient Facility Fee (e.g., Ambulatory Surgery Center) |
More Limited Benefits | Outpatient Rehabilitation Services Habilitation Services Dental Check-Up for Children Chiropractic Care Diabetes Education Rehabilitative Occupational and Rehabilitative Physical Therapy Rehabilitative Speech Therapy |
More Excluded Benefits | Skilled Nursing Facility Acupuncture Bariatric Surgery Cosmetic Surgery Hearing Aids Long Term Care Private-Duty Nursing Weight Loss Programs Routine Foot Care Dental Care - Adult Abortion for Which Public Funding is Prohibited Nutritional Counseling Long-Term/Custodial Nursing Home Care |
ObamaCare’s Gold Plan is a type of Metal Plan on the Health Insurance Marketplace. Gold Plans qualify for Tax Credits, have high premiums, and good cost sharing. Gold plans mean higher premiums, less Tax Credits, but much better cost sharing on average than Silver or Bronze.
The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Gold Plan typically pays 80% of covered medical costs.
The monthly premium for a Gold 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 your geographic region. You can use HealthPocket’s comparison tool to compare Gold Plan premiums in your area.
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.com is a free information source. 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. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. While on our site, if you click on a plan or link, you may be directed to one of our partners who offers health insurance products. HealthPocket, Inc. is part of the Benefytt Technologies, Inc. family of companies.
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.com is a free information source. 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. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. While on our site, if you click on a plan or link, you may be directed to one of our partners who offers health insurance products. HealthPocket, Inc. is part of the Benefytt Technologies, Inc. family of companies.
Quotes are provided by our partner. You are now leaving our site.