BlueCross B15E $0 virtual care from Teladoc Health®

BlueCross BlueShield of Tennessee
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Plan overview
Medical deductible

Individual: $10600

Family: $21200

Per Person: $10600


Prescription drug deductible

Individual: $0

Family: $0

Per Person: $0


Combined medical and drug out of pocket maximum

Individual: $10600

Family: $21200

Per Person: $10600

Office visit
Primary Doctor

CoPay: Not Applicable

CoInsurance: No Charge after deductible

Covered: Covered

Benefit Explanation: $0 Virtual care for telehealth services are available through Teladoc with your plan. Regular benefits apply for telehealth services provided by other network providers.


Specialist

CoPay: Not Applicable

CoInsurance: No Charge after deductible

Covered: Covered

Prescription drug information
Preferred brand drugs

CoPay: Not Applicable

CoInsurance: No Charge after deductible

Covered: Covered

Limit Quantity:

Limit Unit:

Benefit Explanation: When a Brand Drug is chosen and a Generic Drug equivalent is available, You will pay a Penalty for the difference between the cost of the Brand Drug and the Generic Drug.


Non preferred brand drugs

CoPay: Not Applicable

CoInsurance: No Charge after deductible

Covered: Covered

Limit Quantity:

Limit Unit:

Benefit Explanation: When a Brand Drug is chosen and a Generic Drug equivalent is available, You will pay a Penalty for the difference between the cost of the Brand Drug and the Generic Drug.


Generic drugs

CoPay: Not Applicable

CoInsurance: No Charge after deductible

Covered: Covered

Limit Quantity:

Limit Unit:

Benefit Explanation:


Specialty drugs

CoPay: Not Applicable

CoInsurance: No Charge after deductible

Covered: Covered

Limit Quantity:

Limit Unit:

Benefit Explanation: Up to a 30-day supply. Must use a pharmacy in the specialty pharmacy network.

Inpatient coverage
Hospital services

CoPay: Not Applicable

CoInsurance: No Charge after deductible

Covered: Covered

Benefit Explanation: Prior Authorization required (except maternity). Penalties include reduced benefits or denial of claim.


Inpatient services

CoPay: Not Applicable

CoInsurance: No Charge after deductible

Covered: Covered

Benefit Explanation: Prior Authorization required (except maternity). Penalties include reduced benefits or denial of claim.

Emergency and urgent care
Emergency room

CoPay: $750.00 Copay with deductible

CoInsurance: No Charge after deductible

Covered: Covered


Urgent care facility

CoPay: Not Applicable

CoInsurance: No Charge after deductible

Covered: Covered

Benefit Explanation:

Maternity
Labor and delivery hospital stay

CoPay: Not Applicable

CoInsurance: No Charge after deductible

Covered: Covered


Pre and Postnatal office visit

CoPay: Not Applicable

CoInsurance: No Charge after deductible

Covered: Covered

Vision
Routine Eye Exams for Children

CoPay: Not Applicable

CoInsurance: No Charge

Covered: Covered

Limit Quantity: 1

Limit Unit: Exam(s) per Benefit Period

Major dental care
Routine dental checkups for children

CoPay: Not Applicable

CoInsurance: No Charge

Covered: Covered

Limit Quantity: 1

Limit Unit: Exam(s) per 6 Months


Routine dental checkups for adults

CoPay:

CoInsurance:

Covered: Not Covered

Limit Quantity:

Limit Unit:

Benefit Explanation:

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These policies have exclusions, limitations, reduction of benefits, terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call or write your insurance agent or the company (whichever is applicable).

©1998-2015 BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield Association. BlueCross BlueShield of Tennessee is a Qualified Health Plan issuer in the Health Insurance Marketplace. 1 Cameron Hill Circle, Chattanooga TN 37402-0001