CPN North Central Catastrophic 9450

Health Insurance Plan Details (2024 Plan)

by Blue Cross of Idaho

Monthly Premium

POS
$ubsidy
Catastrophic
Deductible
$9,450 /yr
Max Out-of-Pocket
$9,450 /yr

Details

Deductible (per individual) $9,450 /yr
Deductible (per family) $18,900 /yr
Max Out-of-Pocket (per individual) $9,450 /yr
Max Out-of-Pocket (per family) $18,900 /yr
Drug Deductible (per individual)
Drug Deductible (per family)
Drug Max Out-of-Pocket (per individual)
Drug Max Out-of-Pocket (per family)
Plan Type POS
Includes Child Dental? No
Includes Adult Dental? No
Medical Services
Preventive Care No Charge
Primary Care Visit $30 Copay
Specialist Visit Not Applicable
Emergency Room Not Applicable
Inpatient Facility Not Applicable
Inpatient Physician Not Applicable
Drug Costs
Generic Drugs Not Applicable
Preferred Brand Drugs Not Applicable
Non-preferred Brand Drugs Not Applicable
Specialty Drugs Not Applicable

Plan Documents

Summary of Benefits and Coverage SBC doc
Provider Directory Doctor lookup
Drug Formulary List n/a

* Figures shown are only for in-network medical costs

** Please check with insurance company if Copay and Coinsurance rates are before or after the deductible


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