Insurance Type | ACA (Obamacare) |
Plan Name | Blue Saver Bronze |
Plan ID | hhs-46944AL0460001 |
Plan Year | 2021 |
Insurance Provider | Blue Cross Blue Shield of Alabama |
Metal Level | Expanded Bronze |
Plan Type | PPO |
Deductible | $7,750 |
Out-of-Pocket Maximum | $7,750 |
Plan Highlights |
Costs for Medical Care | |
---|---|
Primary Care Visit to Treat an Injury or Illness | No Charge after deductible |
Specialist Visit | No Charge after deductible |
Laboratory Outpatient and Professional Services | No Charge after deductible |
X-rays and Diagnostic Imaging | No Charge after deductible |
Diagnostic Imaging such as MRIs, CT, and PET scans | No Charge after deductible |
Deductible - Family | $15500 per group |
Out-of-Pocket Maximum - Family | $15500 per group |
Prescription drug coverage | |
---|---|
Generic Drugs | $20 Copay |
Preferred Brand Drugs | No Charge after deductible |
Non-Preferred Brand Drugs | No Charge after deductible |
Specialty Drugs | No Charge 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 | No Charge after deductible |
Inpatient Hospital Services (e.g., Hospital Stay) | No Charge after deductible |
Inpatient Physician and Surgical Services | No Charge after deductible |
Emergency Transportation or Ambulance Service | No Charge after deductible |
Maternity | |
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Prenatal and Postnatal Care | No Charge after deductible |
Delivery and all inpatient services for maternity care | No Charge after deductible |
Mental Health | |
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Mental/Behavioral Health Outpatient Services | No Charge after deductible |
Mental/Behavioral Health Inpatient Services | No Charge after deductible |
Substance use disorder outpatient services | No Charge after deductible |
Substance use disorder inpatient services | No Charge 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 Air Ambulance |
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 |
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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 Benefytt Technologies, Inc. family of companies.
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