Blue Advantage Silver Preferred | $0 Deductible | $0 PCP | $0 Tier 1 Rx | Nationwide Doctors (CSR 94%) – PPO

Description

This plan has 94% cost sharing reduction [Popular Plan]

Health Care Plan Details

Network type	PPO
Deductible	Success Your progress has been saved. We have sent an email to with a link to continue your application ×
Out-of-pocket max	$1,150 per person $2,300 per family
Metal tier	Silver

Visit Copay

Primary care visit	No charge
Specialist visit	$20 copay
Preventive care visit	No charge

Urgent, Emergency Care, and Hospital Care

Urgent care	$20 copay
Emergency room	30% coinsurance
Ambulance	30% coinsurance
Hospital stay (facility)	30% coinsurance
Hospital stay (physician)	30% coinsurance
Outpatient procedure (facility)	30% coinsurance
Outpatient procedure (physician)	30% coinsurance
Physical rehabilitation	$20 copay

Maternitowny and Pregnancy

Well baby care	No charge
Labor, delivery, hospital stay	30% coinsurance

Pharmacy, Drugs, and Medication

Generic	No charge
Brand	50% coinsurance
Non-preferred Brand	50% coinsurance
Specialty	50% coinsurance

Lab Tests and Diagnostic Procedures

X-rays	30% coinsurance
Imaging (CT/PET/MRI)	30% coinsurance
Blood work	30% coinsurance

Mental and Psychiatric Health Care

Mental Health outpatient services	No charge
Psychiatric hospital stay	30% coinsurance

Health Plan Provider Information

Health Plan Benefits	https://www.bcbsnc.com/assets/shopper/public/pdf/sbc/Blue_Advantage_Silver_Preferred_0_Ded_CSR94_2024.pdf
Drug and medication plan formulary	https://www.myprime.com/content/dam/prime/memberportal/WebDocs/2024/Formularies/HIM/2024_NC_5T_HealthInsuranceMarketplace.pdf
Search doctor list	https://healthnav.bcbsnc.com/?ci=COMMERCIAL&network_id=3