Insurance Type | ACA (Obamacare) |
Plan Name | Blue Advantage Bronze HMO? 302 |
Plan ID | hhs-33602TX0460740 |
Plan Year | 2021 |
Insurance Provider | BlueCross BlueShield of Texas |
Metal Level | Expanded Bronze |
Plan Type | HMO |
Deductible | $0 |
Out-of-Pocket Maximum | $0 |
Plan Highlights |
Access to doctors and hospitals | |
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Provider directory URL | http://www.bcbstx.com/onlinedirectory/index.htm |
Does this plan have access to a national provider network? | No |
Is a referral required to see a Specialist? | Yes - Referrals are required for some services. Please check with your Medical Group for details. |
Does this plan cover services outside plan service area? | Yes - Coverage outside our service area is available for Emergency and Urgent Care services only. |
Does this plan cover services outside the country? | Yes - No coverage for any services, supplies or drugs received by a Member outside of the United States, except for Emergency Care. |
Medical Management Programs | |
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Does this plan offer disease managment programs? | Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy |
Does this plan offer a wellness program? | Not Covered |
Vision Coverage | |
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Routine Eye Exam for Children | Included |
Eye Glasses for Children | Included |
Routine Eye Exam for Adults | Not Covered |
Child Dental Coverage | |
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Child Dental Coverage - Routine Dental Care | Not Covered |
Child Dental Coverage - Basic Dental Care | Not Covered |
Child Dental Coverage - Orthodontia | Not Covered |
Child Dental Coverage - Major Dental Care | Not Covered |
Adult Dental Coverage | |
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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 | |
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More Included Benefits | Other Practitioner Office Visit (Nurse, Physician Assistant) Preventive Care/Screening/Immunization Imaging (CT/PET Scans, MRIs) Outpatient Surgery Physician/Surgical Services Urgent Care Centers or Facilities Inpatient Physician and Surgical Services Durable Medical Equipment Hospice Services Accidental Dental Allergy Testing Chemotherapy Diabetes Education Dialysis Infusion Therapy Laboratory Outpatient and Professional Services Prosthetic Devices Radiation Reconstructive Surgery Rehabilitative Speech Therapy Transplant Treatment for Temporomandibular Joint Disorders Well Baby Visits and Care Prescription Drugs Other Outpatient Facility Fee (e.g., Ambulatory Surgery Center) |
More Limited Benefits | Skilled Nursing Facility Hearing Aids Home Health Care Services Outpatient Rehabilitation Services Habilitation Services Chiropractic Care Rehabilitative Occupational and Rehabilitative Physical Therapy |
More Excluded Benefits | Acupuncture Bariatric Surgery Cosmetic Surgery Infertility Treatment Long Term Care Private-Duty Nursing Weight Loss Programs Dental Check-Up for Children 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.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.
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