Lifestyle and Health
Ken is a sole proprietor in his early 20's. He's very active. In fact, he recently recovered from an injury he received playing football with friends. The whole experience helped him see the value of maintaining health coverage with an individual plan from BlueCross BlueShield of Tennessee. The plan enables him access to doctor's visits and prescriptions with small copays. And, if something more serious happens, the plan keeps the amount he'll be responsible for to a minimum.
Product Details
PremierBlue Individual PPO Plan - A02
- $1,000 deductible
- $4,000 out-of-pocket max
- $25/$40 Office Visit Copay
- $10/$35/$50 Prescription Drug Plan (with $200 Brand deductible)
- Most services covered at 80%/20% coinsurance after deductible
- Added optional DentalBlue coverage
Coverage
PremierBlue Individual PPO Plan - A02 covers:
- Physician office visits - 100% after $25 copay
- Specialist office visits - 100% after $40 copay
- Preventive office visits - 100% after $25 copay
- Inpatient/Outpatient services - 80% after deductible
- ER/Ambulance - $100 copay, then 80% after deductible
- Home Health - 80% after deductible (limited visits)
- Hospice - 100% after deductible
- Therapy - 80% after deductible (limited visits)
- Behavioral Health - 60% after deductible (limited visits) for inpatient, 50% after deductible ($1,000 per calendar year limit) for outpatient.
- Prescription Drugs - $10 for generic drugs, $35 for preferred brands, $50 for non-preferred brands - after $200 deductible for brands.
- BluePerks discounts of up to 30% on certain non-covered services.
Online Tools & Support
Ken can use BlueAccess to look up benefits coverage, applied deductibles, claims payment details, prior authorization status, order ID cards and more online - anytime day or night. Perfect for those people, like Ken, who work odd hours and prefer to manage their health plan on their own - like online banking.
Search for doctors, hospitals and other health care professionals by your plan's Blue Network (P, S, C or K), or physician specialization, location and other criteria using the Find A Doctor tool. This tool proved to be very helpful in locating a physician when Ken busted his finger.
Just by flashing his I.D. card, Ken can receive discounts of up to 30 percent on non-covered services like gym memberships, vitamins, massage therapy, cosmetic surgery, and more with BluePerks. Because of BluePerks discounts, Ken can afford to join the gym and get regular massages.
