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Bronze B07S, Network S
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Bronze B07S, Network S

Overview
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Bronze B07S, Network S is an individual health health plan issued by BlueCross BlueShield of Tennessee and is available for the year 2019. This health plan is offered by the federal government through HealthCare.gov and the Affordable Care Act (ACA).

Where Do I Need to Live to Quality for this Plan?

This plan is available for qualifying individuals who live in Decatur county, Tennessee.

What Type of Health Plan Is This?

This plan is an EPO plan, which is also known as an "Exclusive Provider Organization." An EPO is a managed care plan where services are covered so long as the the hospitals, dentists, and other health providers in the plan's network are used.

Where Can I Buy This Plan?

You can purchase this plan at HealthCare.gov.

About
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Issuer
BlueCross BlueShield of Tennessee
Plan ID
14002TN0400004
Coverage area
Decatur County, Tennessee
Phone
Local Phone: 1-423-535-5600
Toll-Free: 1-800-565-9140
TTY:
Plan type
EPO
Coverage type
Medical deductible
$5,650
Out-of-pocket maximum
$6,650
Generic drug co-pay
50% Coinsurance after deductible
Preferred brand drug co-pay
50% Coinsurance after deductible
Primary care physician visit cost
50% Coinsurance after deductible
Specialist doctor visit cost
50% Coinsurance after deductible
Doctor Visits
Primary Care Visit 50% Coinsurance after deductible
Specialist Visit 50% Coinsurance after deductible
Emergency Room Visit 50% Coinsurance after deductible
Inpatient Facility Visit 50% Coinsurance after deductible
Inpatient Physician Visit 50% Coinsurance after deductible
Prescription Drugs
Generic Drugs 50% Coinsurance after deductible
Preferred Brand Drugs 50% Coinsurance after deductible
Non-preferred Brand Drugs 50% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $5,650
Medical Maximum Out Of Pocket (Individual) $6,650
Medical Deductible (Family) $11,300
Medical Maximum Out Of Pocket (Family) $13,300
Drug Deductible
Drug Deductible (Individual) Included in Medical
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) Included in Medical
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 100.00%
Premium Child Age 0-14 229
Premium Child Age 18 273
Premium Adult Individual Age 21 299
Premium Adult Individual Age 27 313
Premium Adult Individual Age 30 339
Premium Adult Individual Age 40 382
Premium Adult Individual Age 50 534
Premium Adult Individual Age 60 812
Premium Couple 21 599
Premium Couple 30 679
Premium Couple 40 765
Premium Couple 50 1,069
Premium Couple 60 1,625
Couple+1 child, Age 21 828
Couple+1 child, Age 30 909
Couple+1 child, Age 40 994
Couple+1 child, Age 50 1,298
Couple+2 children, Age 21 1,057
Couple+2 children, Age 30 1,138
Couple+2 children, Age 40 1,223
Couple+2 children, Age 50 1,528
Couple+3 or more Children, Age 21 1,286
Couple+3 or more Children, Age 30 1,367
Couple+3 or more Children, Age 40 1,452
Couple+3 or more Children, Age 50 1,757
Individual+1 child, Age 21 528
Individual+1 child, Age 30 569
Individual+1 child, Age 40 611
Individual+1 child, Age 50 764
Individual+2 children, Age 21 757
Individual+2 children, Age 30 798
Individual+2 children, Age 40 841
Individual+2 children, Age 50 993
Individual+3 or more children, Age 21 986
Individual+3 or more children, Age 30 1,027
Individual+3 or more children, Age 40 1,070
Individual+3 or more children, Age 50 1,222
Reference
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  • HealthCare.gov. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov
  • The 'metal' categories: Bronze, Silver, Gold & Platinum. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plans-categories
  • Health insurance plan & network types: HMOs, PPOs, and more. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plan-types