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BlueCross B19S $60 PCP Copay + $0 virtual care from Teladoc Health
Health Insurance Plan Details (2026 Plan)
by BlueCross BlueShield of Tennessee
Monthly Premium
EPO
$ubsidy
HSA
Bronze
- Deductible
- N/A /yr
- Max Out-of-Pocket
- N/A /yr
Details
| Deductible (per individual) | $0 /yr |
| Deductible (per family) | $0 /yr |
| Max Out-of-Pocket (per individual) | $10,600 /yr |
| Max Out-of-Pocket (per family) | $21,200 /yr |
| Plan Type | EPO |
| Includes Child Dental? | Yes |
| Includes Adult Dental? | No |
Out-of-Pocket Costs
| Preventive Care | No Charge |
| Primary Care Visit | $60 Copay |
| Specialist Visit | $130 Copay |
| Emergency Room | $2500 Copay |
| Inpatient Facility | $3000 Copay per Day |
| Inpatient Physician | Not Applicable |
| Generic Drugs | $35 Copay |
| Preferred Brand Drugs | $195 Copay |
| Non-preferred Brand Drugs | $250 Copay |
| Specialty Drugs | 50.00% Coinsurance after deductible |
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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