BlueSelect Bronze Plus 1449P Plan Details for 2021- HealthPocket

BlueSelect Bronze Plus 1449P

$404.45/mo

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Zip Code33186
Applicant10/25/1986 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameBlueSelect Bronze Plus 1449P
Plan IDhhs-16842FL0240001
Plan Year2021
Insurance ProviderBlue Cross Blue Shield of Florida
Metal LevelExpanded Bronze
Plan TypeEPO
Deductible$8,500
Out-of-Pocket Maximum$8,550
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$100 Copay after deductible
Specialist Visit$100 Copay after deductible
Laboratory Outpatient and Professional Services$100 Copay after deductible
X-rays and Diagnostic Imaging$100 Copay after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans$100 Copay after deductible
Deductible - Family$17000 per group
Out-of-Pocket Maximum - Family$17100 per group

Prescription drug coverage

Generic Drugs$100 Copay after deductible
Preferred Brand Drugs$100 Copay after deductible
Non-Preferred Brand Drugs$100 Copay after deductible
Specialty Drugs$100 Copay after deductible

Access to doctors and hospitals

Provider directory URLhttps://providersearch.floridablue.com/providersearch/pub/index.htm
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 - Covered services as outlined in the member contract.
Does this plan cover services outside the country?Yes - Covered services as outlined in the member contract.

Hospital services

Emergency Room Services$100 Copay after deductible
Inpatient Hospital Services (e.g., Hospital Stay)$100 Copay after deductible
Inpatient Physician and Surgical Services$100 Copay after deductible
Emergency Transportation or Ambulance Service$100 Copay after deductible

Maternity

Prenatal and Postnatal Care$100 Copay after deductible
Delivery and all inpatient services for maternity care$100 Copay after deductible

Mental Health

Mental/Behavioral Health Outpatient Services$100 Copay after deductible
Mental/Behavioral Health Inpatient Services$100 Copay after deductible
Substance use disorder outpatient services$100 Copay after deductible
Substance use disorder inpatient services$100 Copay after deductible

Medical Management Programs

Does this plan offer disease managment programs?Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, 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 CareIncluded
Child Dental Coverage - Basic Dental CareIncluded
Child Dental Coverage - OrthodontiaIncluded
Child Dental Coverage - Major Dental CareIncluded

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 Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Durable Medical Equipment
Hospice Services
Routine Foot Care
Dental Anesthesia
Diabetes Care Management
Accidental Dental
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Bone Marrow Testing
Bone Marrow Transplant
Congenital Anomaly, including Cleft Lip/Palate
Nutrition/Formulas
Off Label Prescription Drugs
Osteoporosis
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
More Limited BenefitsSkilled Nursing Facility
Home Health Care Services
Outpatient Rehabilitation Services
Habilitation Services
Dental Check-Up for Children
Chiropractic Care
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
More Excluded BenefitsAcupuncture
Bariatric Surgery
Cosmetic Surgery
Hearing Aids
Infertility Treatment
Long Term Care
Private-Duty Nursing
Weight Loss Programs
Dental Care - Adult
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $191Health First GYM ACCESS Catastrophic HMO 1746$8,550.00Select
from $210AdventHealth GYM ACCESS Catastrophic HMO 1748$8,550.00Select
from $244Oscar Secure (Free 24/7 Virtual Visits + Free Personal Care Tea$8,550.00Select
from $259Gym Access IND Essential Plus Catastrophic HMO 36$8,550.00Select
from $280Gym Access IND Essential Plus Catastrophic POS 37$8,550.00Select
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  • Phone Number
    (305) 380-6773
  • Office Locations
    9000 Sw 137th Ave
    Miami, FL 33186
9000 Sw 137th Ave Miami FL, 33186

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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.