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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 Grundy 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
14002TN0400003
Coverage area
Grundy 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 0-14 216
Premium Child Age 18 258
Premium Adult Individual Age 21 282
Premium Adult Individual Age 27 296
Premium Adult Individual Age 30 320
Premium Adult Individual Age 40 361
Premium Adult Individual Age 50 504
Premium Adult Individual Age 60 767
Premium Couple 21 565
Premium Couple 30 641
Premium Couple 40 722
Premium Couple 50 1,009
Premium Couple 60 1,534
Couple+1 child, Age 21 781
Couple+1 child, Age 30 857
Couple+1 child, Age 40 938
Couple+1 child, Age 50 1,225
Couple+2 children, Age 21 997
Couple+2 children, Age 30 1,074
Couple+2 children, Age 40 1,154
Couple+2 children, Age 50 1,442
Couple+3 or more Children, Age 21 1,213
Couple+3 or more Children, Age 30 1,290
Couple+3 or more Children, Age 40 1,371
Couple+3 or more Children, Age 50 1,658
Individual+1 child, Age 21 498
Individual+1 child, Age 30 537
Individual+1 child, Age 40 577
Individual+1 child, Age 50 721
Individual+2 children, Age 21 715
Individual+2 children, Age 30 753
Individual+2 children, Age 40 793
Individual+2 children, Age 50 937
Individual+3 or more children, Age 21 931
Individual+3 or more children, Age 30 969
Individual+3 or more children, Age 40 1,009
Individual+3 or more children, Age 50 1,153
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