2018 Blue Precision Bronze HMO 205 Plan Details - HealthPocket

Blue Precision Bronze HMO 205

$379.31/mo

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Zip Code60629
Applicant8/21/1983 Male
Coverage Start8/23/2018
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameBlue Precision Bronze HMO 205
Plan IDhhs-36096IL0810083
Insurance ProviderBlue Cross Blue Shield of Illinois
Metal LevelBronze
Plan TypeHMO
Deductible$6,000
Out-of-Pocket Maximum$7,350
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$50 Copay
Specialist Visit$85 Copay
Laboratory Outpatient and Professional Services$50 Copay
X-rays and Diagnostic Imaging$100 Copay
Diagnostic Imaging such as MRIs, CT, and PET scans$300 Copay
Deductible - Family$14700 per group
Out-of-Pocket Maximum - Family$14700 per group

Prescription drug coverage

Generic Drugs10.00% Coinsurance after deductible
Preferred Brand Drugs20.00% Coinsurance after deductible
Non-Preferred Brand Drugs30.00% Coinsurance after deductible
Specialty Drugs40.00% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttp://www.bcbsil.com/providers/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$1000 Copay with deductible, 40.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Inpatient Hospital Services (e.g., Hospital Stay)$850 Copay per Day
Inpatient Physician and Surgical Services40.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service40.00% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care$50 Copay
Delivery and all inpatient services for maternity care$850 Copay

Mental Health

Mental/Behavioral Health Outpatient Services$50 Copay
Mental/Behavioral Health Inpatient Services$850 Copay per Day
Substance use disorder outpatient services$50 Copay
Substance use disorder inpatient services$850 Copay per Day

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 AdultsIncluded

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
Skilled Nursing Facility
Bariatric Surgery
Cosmetic Surgery
Private-Duty Nursing
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
Outpatient Rehabilitation Services
Habilitation Services
Durable Medical Equipment
Hospice Services
Routine Foot Care
Accidental Dental
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Prescription Drugs Other
More Limited BenefitsHearing Aids
Infertility Treatment
Chiropractic Care
More Excluded BenefitsAcupuncture
Long-Term/Custodial Nursing Home Care
Weight Loss Programs
Dental Check-Up for Children
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $262
Blue FocusCare Bronze 209
$6,000.00Select
from $310
Blue Precision Bronze HMO 205
$6,000.00Select
from $320
Blue FocusCare Bronze HMO 209
$6,000.00Select
from $322
HMO HSA 6000 Elite Bronze
$6,000.00Select
from $329
HMO HSA 6000 OSF Bronze
$6,000.00Select
  • What is a bronze plan?

    Bronze Plan is a type of Metal Plan on the Health Insurance Marketplace. Bronze Plans qualify for Tax Credits and have low premiums. Generally speaking, a Bronze Plan is intended to have the lowest premium of the 4 new categories of health plans under the Affordable Care Act but charge the highest out-of-pocket costs for healthcare services.

  • How are Bronze Plans different than other Obamacare health plans?

    The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Bronze Plan pays 60% of the covered medical costs among its enrollees while the other Obamacare health plans pay a higher percentage of these costs.

  • How much does a Bronze Plan cost?

    The monthly premium for a Bronze 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 the region in which you live. You can use HealthPocket’s comparison tool to compare Bronze Plan premiums in your area. Another important factor to remember is Advanced Premium Tax Credits which can subsidize bronze plan premiums if an individual meets eligibility criteria.

  • When Can I Enroll in a Bronze Plan?

    The annual enrollment period for the 2018 plan year will begin on November 1, 2017 and continue through December 15, 2017.

    In 2015 there had been a Special Enrollment Period for many facing the uninsured penalty on their 2014 tax return. There is no guarantee that a similar Special Enrollment Period will be granted in 2017. See our Open Enrollment article for more information.

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