BESTOne Advantage Gold – PPO
Network type: PPO
Coverage tier: High
Basic Dental: 10% after deductible
Major dental care: 50% after deductible
Orthodontics: Not covered
Exams: No charge
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BESTOne Base Silver – PPO
Network type: PPO
Coverage tier: Low
Basic Dental: 30% after deductible
Major dental care: 100%
Orthodontics: Not covered
Exams: No charge -
BESTOne Basic Silver – PPO
Network type: PPO
Coverage tier: Low
Basic Dental: 50% after deductible
Major dental care: 70% after deductible
Orthodontics: Not covered
Exams: No charge -
BESTOne Gold Plus – PPO
Network type: PPO
Coverage tier: High
Basic Dental: 10% after deductible
Major dental care: 60% after deductible
Orthodontics: Not covered
Exams: No charge -
Blue Advantage Bronze HMO℠ 204 – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $45 copay
Specialist visit: 50% coinsurance after deductible
Urgent care visit: $60 copay -
Blue Advantage Bronze HMO℠ 301 – HMO
Network type: HMO
Coverage tier: Bronze
Primary care visit: No charge after deductible
Specialist visit: No charge after deductible
Urgent care visit: No charge after deductible -
Blue Advantage Bronze HMO℠ 302 – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: No charge after deductible
Specialist visit: No charge after deductible
Urgent care visit: No charge after deductible -
Blue Advantage Bronze HMO℠ 707 – HMO
Network type: HMO
Coverage tier: Expanded Bronze
Primary care visit: $50 copay
Specialist visit: $100 copay
Urgent care visit: $75 copay -
Blue Advantage Gold HMO℠ 206 – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $30 copay
Specialist visit: 40% coinsurance after deductible
Urgent care visit: $45 copay -
Blue Advantage Gold HMO℠ 603 – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $45 copay
Specialist visit: 40% coinsurance after deductible
Urgent care visit: $60 copay -
Blue Advantage Gold HMO℠ 706 – HMO
Network type: HMO
Coverage tier: Gold
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $45 copay -
Blue Advantage Plus Bronze℠ 303 – POS
Network type: POS
Coverage tier: Expanded Bronze
Primary care visit: $80 copay
Specialist visit: 50% coinsurance after deductible
Urgent care visit: $120 copay -
Blue Advantage Plus Bronze℠ 305 – POS
Network type: POS
Coverage tier: Bronze
Primary care visit: 40% coinsurance after deductible
Specialist visit: 50% coinsurance after deductible
Urgent care visit: 50% coinsurance after deductible -
Blue Advantage Plus Bronze℠ 707 – POS
Network type: POS
Coverage tier: Expanded Bronze
Primary care visit: $50 copay
Specialist visit: $100 copay
Urgent care visit: $75 copay -
Blue Advantage Plus Gold℠ 203 – POS
Network type: POS
Coverage tier: Gold
Primary care visit: $20 copay
Specialist visit: $45 copay
Urgent care visit: $45 copay -
Blue Advantage Plus Gold℠ 706 – POS
Network type: POS
Coverage tier: Gold
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $45 copay