Blue Advantage Plus Bronze? 501 Plan Details for 2021- HealthPocket

Blue Advantage Plus Bronze? 501

$424.90/mo

Apply For This Plan

Zip Code79936
Applicant11/26/1985 Male
Apply Now

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameBlue Advantage Plus Bronze? 501
Plan IDhhs-33602TX0770270
Plan Year2021
Insurance ProviderBlueCross BlueShield of Texas
Metal LevelExpanded Bronze
Plan TypeHMO
Deductible$5,000
Out-of-Pocket Maximum$6,900
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness50.00% Coinsurance after deductible
Specialist Visit50.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services40.00% Coinsurance after deductible
X-rays and Diagnostic Imaging40.00% Coinsurance after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans40.00% Coinsurance after deductible
Deductible - Family$13800 per group
Out-of-Pocket Maximum - Family$13800 per group

Prescription drug coverage

Generic Drugs20.00% Coinsurance after deductible
Preferred Brand Drugs30.00% Coinsurance after deductible
Non-Preferred Brand Drugs35.00% Coinsurance after deductible
Specialty Drugs45.00% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttp://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 - This plan does not cover any services and/or supplies provided to a member outside of the United States, if the member traveled to the location for the purposes of receiving medical services, supplies, or drugs.

Hospital services

Emergency Room Services$950 Copay with deductible, 50.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Inpatient Hospital Services (e.g., Hospital Stay)$850 Copay per Stay with deductible, 50.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Inpatient Physician and Surgical Services50.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service50.00% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care50.00% Coinsurance after deductible
Delivery and all inpatient services for maternity care$850 Copay with deductible, 50.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.

Mental Health

Mental/Behavioral Health Outpatient Services50.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services$850 Copay per Stay with deductible, 50.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Substance use disorder outpatient services50.00% Coinsurance after deductible
Substance use disorder inpatient services$850 Copay per Stay with deductible, 50.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.

Medical Management Programs

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

Routine Eye Exam for ChildrenIncluded
Eye Glasses for ChildrenIncluded
Routine Eye Exam for AdultsNot Covered

Child Dental Coverage

Child Dental Coverage - Routine Dental CareNot Covered
Child Dental Coverage - Basic Dental CareNot Covered
Child Dental Coverage - OrthodontiaNot Covered
Child Dental Coverage - Major Dental CareNot Covered

Adult Dental Coverage

Adult Dental Coverage - Routine Dental CareNot Covered
Adult Dental Coverage - Basic Dental CareNot Covered
Adult Dental Coverage - OrthodontiaNot Covered
Adult Dental Coverage - Major Dental CareNot Covered

Exclusions and Limitations

More Included BenefitsOther 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 BenefitsSkilled Nursing Facility
Hearing Aids
Home Health Care Services
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Rehabilitative Occupational and Rehabilitative Physical Therapy
More Excluded BenefitsAcupuncture
Bariatric Surgery
Cosmetic Surgery
Infertility Treatment
Private-Duty Nursing
Weight Loss Programs
Dental Check-Up for Children
Routine Foot Care
Abortion for Which Public Funding is Prohibited
Nutritional Counseling
Long-Term/Custodial Nursing Home Care
PremiumPlan NameDeductible
from $361
Ambetter Balanced Care 204 HSA (2021)
$4,800.00Select
from $378
Ambetter Balanced Care 204 HSA (2021) + Vision + Adult Dental
$4,800.00Select
from $405
BSW Prime Silver HMO 010 ($0 Preventive Care and Preventive Rx
$4,950.00Select
from $407
Blue Advantage Plus Bronze? 501
$5,000.00Select
from $467
Ambetter Balanced Care 25 HSA (2021)
$4,800.00Select
/
Please select the correct zip
Huma, Lodhi
View All Details
Maria, Cardenas
View All Details
Patricia, Azarcon-samonte
View All Details
Thomas, Hoffer
View All Details
Nathaniel, Griffith
View All Details
Eep Internal Medicine Pa
View All Details
Stephanie, Moreno
View All Details
915 Pediatrics Pllc
View All Details
Isabel, Cano
View All Details
Sun Psychiatry Pllc
View All Details
Dc Gastro Konsult
View All Details
Stephanie Gonzalez Dpm Pa
View All Details
Patricia, Montiel Mendez
View All Details
Grace, Rodriguez
View All Details
Irving, Palacios Y Trejo
View All Details
Marisela, Gomez
View All Details
Alyson, Martinez
View All Details
Dawn, Sackett
View All Details
Erin, Ginithan
View All Details
Saranya, Gangupalli
View All Details
Elena, Paul
View All Details
Jose, Ruiz
View All Details
Huma Lodhi, M.D.
View All Details
  • Phone Number
    (915) 225-3807
  • Office Locations
    11351 James Watt Dr
    El Paso, TX 79936
11351 James Watt Dr El Paso TX, 79936

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.