BlueDental Copayment QF – PPO
Network type: PPO
Coverage tier: Low
Basic Dental: $17 after deductible
Major dental care: $221 after deductible
Orthodontics: Not covered
Exams: $10
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BlueOptions Bronze (HSA) 24J01-10 (Rewards $$$ / $4 Condition Care Rx) – PPO
Network type: PPO
Coverage tier: Expanded Bronze
Primary care visit: No charge after deductible
Specialist visit: No charge after deductible
Urgent care visit: No charge after deductible -
BlueOptions Bronze 24J01-04 ($0 Virtual Visits / 3 PCP Visits for $0 then $40 / Rewards $$$) – PPO
Network type: PPO
Coverage tier: Expanded Bronze
Primary care visit: No charge
Specialist visit: $20 copay
Urgent care visit: $70 copay -
BlueOptions Bronze 24J01-04 ($0 Virtual Visits / 3 PCP Visits for $0 then $40 / Rewards $$$) – PPO
Network type: PPO
Coverage tier: Expanded Bronze
Primary care visit: No charge
Specialist visit: $20 copay
Urgent care visit: $70 copay -
BlueOptions Bronze 24J01-06 ($0 Virtual Visits / Rewards $$$) – PPO
Network type: PPO
Coverage tier: Bronze
Primary care visit: No charge
Specialist visit: $20 copay
Urgent care visit: 50% coinsurance after deductible -
BlueOptions Bronze 24J01-17 ($0 Virtual Visits / $50 PCP Visits / Rewards $$$) – PPO
Network type: PPO
Coverage tier: Expanded Bronze
Primary care visit: No charge
Specialist visit: $20 copay
Urgent care visit: $85 copay -
BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards $$$) – PPO
Network type: PPO
Coverage tier: Expanded Bronze
Primary care visit: $50 copay
Specialist visit: $100 copay
Urgent care visit: $75 copay -
BlueOptions Gold 24J01-09 ($0 Virtual Visits / $20 PCP Visits / $15 Generic Meds / Rewards $$$) – PPO
Network type: PPO
Coverage tier: Gold
Primary care visit: No charge
Specialist visit: $20 copay
Urgent care visit: $60 copay -
BlueOptions Gold 24J01-12 ($0 Virtual Visits / $20 Labs / Rewards $$$) – PPO
Network type: PPO
Coverage tier: Gold
Primary care visit: No charge
Specialist visit: $20 copay
Urgent care visit: $75 copay -
BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards $$$) – PPO
Network type: PPO
Coverage tier: Gold
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $45 copay -
BlueOptions Platinum 24J01-05 ($0 Virtual Visits / Rewards $$$) – PPO
Network type: PPO
Coverage tier: Platinum
Primary care visit: No charge
Specialist visit: $20 copay
Urgent care visit: $35 copay -
BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards $$$) – PPO
Network type: PPO
Coverage tier: Platinum
Primary care visit: $10 copay
Specialist visit: $20 copay
Urgent care visit: $15 copay -
BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards $$$) – PPO
Network type: PPO
Coverage tier: Platinum
Primary care visit: $10 copay
Specialist visit: $20 copay
Urgent care visit: $15 copay -
BlueOptions Silver 24J01-03 ($0 Virtual Visits / $0 Labs / Rewards $$$) – PPO
Network type: PPO
Coverage tier: Silver
Primary care visit: No charge
Specialist visit: $20 copay
Urgent care visit: $100 copay after deductible -
BlueOptions Silver 24J01-07 ($0 Virtual Visits / Rewards $$$) – PPO
Network type: PPO
Coverage tier: Silver
Primary care visit: No charge
Specialist visit: $20 copay
Urgent care visit: $100 copay -
Bronze Classic | MercyOne – EPO
Network type: EPO
Coverage tier: Expanded Bronze
Primary care visit: $50 copay
Specialist visit: $125 copay after deductible
Urgent care visit: $75 copay