Premera Blue Cross Preferred Bronze 5800 HSA

Premera Blue Cross Blue Shield of Alaska
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Plan overview
Medical deductible

Individual: $5800

Family: $11600

Per Person: $5800


Prescription drug deductible

Individual: $0

Family: $0

Per Person: $0


Combined medical and drug out of pocket maximum

Individual: $8000

Family: $16000

Per Person: $8000

Office visit
Primary Doctor

CoPay: Not Applicable

CoInsurance: 35.00% Coinsurance after deductible

Covered: Covered

Benefit Explanation:


Specialist

CoPay: Not Applicable

CoInsurance: 35.00% Coinsurance after deductible

Covered: Covered

Prescription drug information
Preferred brand drugs

CoPay: Not Applicable

CoInsurance: 35.00% Coinsurance after deductible

Covered: Covered

Limit Quantity: 90

Limit Unit: Item(s) per Month

Benefit Explanation: Up to 90 day supply Retail. 90 day supply for Mail order.


Non preferred brand drugs

CoPay: Not Applicable

CoInsurance: 35.00% Coinsurance after deductible

Covered: Covered

Limit Quantity: 90

Limit Unit: Item(s) per Month

Benefit Explanation: Up to 90 day supply Retail. 90 day supply for Mail order. This tier contains all non-preferred drugs.


Generic drugs

CoPay: Not Applicable

CoInsurance: 35.00% Coinsurance after deductible

Covered: Covered

Limit Quantity: 90

Limit Unit: Item(s) per Month

Benefit Explanation: Up to a 90 day supply Retail; 90 day supply for Mail Order. This tier contains only Preferred Generic Drugs.


Specialty drugs

CoPay: Not Applicable

CoInsurance: 40.00% Coinsurance after deductible

Covered: Covered

Limit Quantity: 30

Limit Unit: Item(s) per Month

Benefit Explanation: 30 day supply Retail and Mail

Inpatient coverage
Hospital services

CoPay: Not Applicable

CoInsurance: 35.00% Coinsurance after deductible

Covered: Covered


Inpatient services

CoPay: Not Applicable

CoInsurance: 35.00% Coinsurance after deductible

Covered: Covered

Emergency and urgent care
Emergency room

CoPay: Not Applicable

CoInsurance: 35.00% Coinsurance after deductible

Covered: Covered


Urgent care facility

CoPay: Not Applicable

CoInsurance: 35.00% Coinsurance after deductible

Covered: Covered

Benefit Explanation:

Maternity
Labor and delivery hospital stay

CoPay: Not Applicable

CoInsurance: 35.00% Coinsurance after deductible

Covered: Covered


Pre and Postnatal office visit

CoPay: Not Applicable

CoInsurance: 35.00% Coinsurance after deductible

Covered: Covered

Vision
Routine Eye Exams for Children

CoPay: Not Applicable

CoInsurance: 35.00%

Covered: Covered

Limit Quantity: 1

Limit Unit: Item(s) per Year

Benefit Explanation: Under age 19, 1 PCY; Over age 19 Not Covered

Major dental care
Routine dental checkups for children

CoPay: Not Applicable

CoInsurance: 10.00%

Covered: Covered

Limit Quantity: 1

Limit Unit: Visit(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).