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Individuals (one-person plans) and families (two or more people) qualify for Flexible Blue II; however, all people covered by Flexible Blue II must be under 65 years old. (Please see Medicare plans if you’re over 65 or are eligible for Medicare.)
| Plan type | PPO |
|---|---|
| Eligibility | Individuals and families under 65 years old |
| Coinsurance | You pay 20% in-network, 40% out-of-network costs |
| Flat copayments | $50 urgent care visits, $150 ER visits |
| Included coverage |
|
| Unique benefits |
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There are five options for families or individuals to choose from and when you're looking at pricing, it's good to keep this in mind: your deductible affects how high your premium will be and what kind of benefits you'll receive.
| Deductible | Out-of-pocket maximum | Monthly rate |
| For individuals: | Starts at $73.43 |
||
|---|---|---|---|
| Plan 1500 | $1,500 | $4,000 | |
| Plan 2500 | $2,500 | $5,000 | |
| Plan 5000 | $5,000 | $5,800 | |
| For families: | |||
| Plan 1500 | $3,000 | $8,000 | |
| Plan 2500 | $5,000 | $10,000 | |
| Plan 5000 | $10,000 | $11,600 |
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| Options |
| Plan Structure: | ||||||
|---|---|---|---|---|---|---|
| Network | PPO | PPO | PPO | |||
| Prescription Coverage | No Discounts available at the BCBSM-negotiated rate |
Yes $10 copay for generic 50% for brand name or specialty drugs |
Yes 50% after deductible |
|||
| Maternity Coverage | No | No | No | |||
| Dental Coverage | Optional (Personal Blue Dental or Personal Blue Dental Plus) | Optional (Personal Blue Dental or Personal Blue Dental Plus) | Optional (Flexible Blue Dental Plus) | |||
| Included Services | Preventive medical, dental and vision | Preventive medical | Preventive medical | |||
| Unique Benefits | Accidental Injury Deductible Waiver | Accidental Injury Deductible Waiver and wellness incentives including diminishing deductible and fitness rewards | HSA-compatible | |||
| Possible Costs: | ||||||
| Deductible | $1,000 |
|
Plan 5000 $5,000 ind. $10,000 fam. |
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| Out-of-pocket maximum | $3,500 |
|
$5,800 ind. $11,600 fam. |
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| Fixed co-pays include | $50 urgent care $150 ER visits (waived if admitted) |
$40 office visits $75 urgent care $250 ER visits (waived if admitted) |
$50 urgent care $150 ER visits (waived if admitted) |
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| Coinsurance | You pay 30% in-network You pay 50% out-of-network |
You pay 30% in-network You pay 50% out-of-network |
You pay 20% in-network You pay 40% out-of-network |
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| Other Highlights | ||||||
| Waiting period for preexisting conditions | 180 days | 180 days | 180 days |
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