BlueCross BlueShield of Tennessee Personal Health Coverage plans provide benefits for:

• Medically necessary and appropriate services in a practitioner's office.
• Routine diagnostic services.
• Injections.
• Prescription drug benefits including $10 generic, $35 BlueCross BlueShield of Tennessee preferred brand, and $50 non-preferred brand name drug copays.  However, there is a $200 deductible on brand name drugs before these copays are available (an optional plan without a deductible is available).
• Inpatient hospitalization including room and board in a semi-private room, general nursing care, medications, injections, diagnostics and special care units.*
• Outpatient facility services, including outpatient surgery centers, hospital outpatient centers and outpatient diagnostic centers.*
• Emergency care services ($100 co-pay before deductible/co-insurance, waived if patient is admitted).
• Skilled nursing and rehabilitation facilities (30 day annual limit).
• Non-routine diagnostic services.
• Therapeutic services including physical therapy, speech therapy, occupational therapy and manipulative therapy (20 visit limit per year, per therapy). Therapeutic services for cardiac and pulmonary rehabilitative services (36 visit limit per year, per therapy).
• Durable medical equipment, prosthetics and orthotics.
• Home health services (40 visit limit per year).
• Ambulance services.
• Hospice.
• Organ Transplants.
• TMJ (non-surgical/$1,500 annual limit).
• Behavioral health programs including coverage for inpatient and outpatient services for care and treatment of mental health disorders and substance abuse disorders (20 day annual inpatient services limit; $1,000 annual outpatient services limit).
• Sterilization.

* Certain services require prior approval. Out-of-network benefits are provided at 50 percent when prior approval is not obtained.