2018 HMO Blue New England Basic Saver Plan Details - HealthPocket

HMO Blue New England Basic Saver

$325.40/mo

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Zip Code02128
Applicant8/21/1983 Male
Coverage Start8/22/2018
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameHMO Blue New England Basic Saver
Plan IDhhs-42690MA1290071
Insurance ProviderBlue Cross Blue Shield of Massachusetts
Metal LevelBronze
Plan TypeHMO
Deductible$3,350
Out-of-Pocket Maximum$6,550
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$60 Copay after deductible
Specialist Visit$75 Copay after deductible
Laboratory Outpatient and Professional Services$60 Copay after deductible
X-rays and Diagnostic Imaging$60 Copay after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans$1000 Copay after deductible
Deductible - Family$6550 per group
Out-of-Pocket Maximum - Family$13100 per group

Prescription drug coverage

Generic Drugs$50 Copay after deductible
Preferred Brand Drugs$175 Copay after deductible
Non-Preferred Brand Drugs$250 Copay after deductible
Specialty Drugs$175 Copay after deductible

Access to doctors and hospitals

Provider directory URLhttp://www.bluecrossma.com/wps/portal/members/using-my-plan/doctors-hospitals/findadoctor/
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?Yes - All specialists except OB/GYN providers
Does this plan cover services outside plan service area?Yes - Emergency and Urgent Care Services only
Does this plan cover services outside the country?Yes - Emergency and Urgent Care Services only

Hospital services

Emergency Room Services$1000 Copay after deductible
Inpatient Hospital Services (e.g., Hospital Stay)$1000 Copay per Stay after deductible
Inpatient Physician and Surgical ServicesNot Applicable
Emergency Transportation or Ambulance ServiceNot Applicable

Maternity

Prenatal and Postnatal CareNot Applicable
Delivery and all inpatient services for maternity care$1000 Copay after deductible

Mental Health

Mental/Behavioral Health Outpatient Services$60 Copay after deductible
Mental/Behavioral Health Inpatient Services$1000 Copay after deductible
Substance use disorder outpatient services$60 Copay after deductible
Substance use disorder inpatient services$1000 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?Included

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)
Bariatric Surgery
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
Chiropractic Care
Diabetes Care Management
Abortion for Which Public Funding is Prohibited
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Rehabilitative Speech Therapy
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Bone Marrow Transplants for Treatment of Breast Cancer
Cardiac Rehabilitation
Clinical Trials
Congenital Anomaly, including Cleft Lip/Palate
Contraceptive Services
Early Intervention Services
Hormone Replacement Therapy (HRT)
Human Leukocyte Antigen Testing
Hypodermic Syringes or Needles
Nutrition/Formulas
Off Label Prescription Drugs
More Limited BenefitsPreventive Care/Screening/Immunization
Skilled Nursing Facility
Hearing Aids
Weight Loss Programs
Outpatient Rehabilitation Services
Habilitation Services
Rehabilitative Occupational and Rehabilitative Physical Therapy
More Excluded BenefitsAcupuncture
Cosmetic Surgery
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Dental Check-Up for Children
Routine Foot Care
Accidental Dental
PremiumPlan NameDeductible
from $293
HNE Wise Saver 3450 HDHP
$3,450.00Select
from $377
Preferred Blue PPO Basic Saver
$3,350.00Select
  • 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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