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Gold G06S, Network S
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Gold G06S, Network S

Overview
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Gold G06S, 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 Madison 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
14002TN0400203
Coverage area
Madison County, Tennessee
Phone
Local Phone: 1-423-535-5600
Toll-Free: 1-800-565-9140
TTY:
Plan type
EPO
Coverage type
Medical deductible
$1,500
Out-of-pocket maximum
$6,350
Generic drug co-pay
$8
Preferred brand drug co-pay
$35
Primary care physician visit cost
$35
Specialist doctor visit cost
$50
Doctor Visits
Primary Care Visit $35
Specialist Visit $50
Emergency Room Visit 20% Coinsurance after deductible
Inpatient Facility Visit 20% Coinsurance after deductible
Inpatient Physician Visit 20% Coinsurance after deductible
Prescription Drugs
Generic Drugs $8
Preferred Brand Drugs $35
Non-preferred Brand Drugs $60
Specialty Drugs $120
Medical Deductible
Medical Deductible (Individual) $1,500
Medical Maximum Out Of Pocket (Individual) $6,350
Medical Deductible (Family) $3,000
Medical Maximum Out Of Pocket (Family) $12,700
Drug Deductible
Drug Deductible (Individual) $0
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) $0
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 100.00%
Premium Child Age 0-14 650
Premium Child Age 18 775
Premium Adult Individual Age 21 849
Premium Adult Individual Age 27 890
Premium Adult Individual Age 30 964
Premium Adult Individual Age 40 1,086
Premium Adult Individual Age 50 1,517
Premium Adult Individual Age 60 2,306
Premium Couple 21 1,699
Premium Couple 30 1,929
Premium Couple 40 2,172
Premium Couple 50 3,035
Premium Couple 60 4,612
Couple+1 child, Age 21 2,349
Couple+1 child, Age 30 2,579
Couple+1 child, Age 40 2,822
Couple+1 child, Age 50 3,685
Couple+2 children, Age 21 2,999
Couple+2 children, Age 30 3,229
Couple+2 children, Age 40 3,472
Couple+2 children, Age 50 4,335
Couple+3 or more Children, Age 21 3,650
Couple+3 or more Children, Age 30 3,879
Couple+3 or more Children, Age 40 4,122
Couple+3 or more Children, Age 50 4,986
Individual+1 child, Age 21 1,499
Individual+1 child, Age 30 1,614
Individual+1 child, Age 40 1,736
Individual+1 child, Age 50 2,167
Individual+2 children, Age 21 2,150
Individual+2 children, Age 30 2,264
Individual+2 children, Age 40 2,386
Individual+2 children, Age 50 2,818
Individual+3 or more children, Age 21 2,800
Individual+3 or more children, Age 30 2,914
Individual+3 or more children, Age 40 3,036
Individual+3 or more children, Age 50 3,468
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