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Blue Advantage Plus Silver℠ 605
Health Insurance Plan Details (2025 Plan)
by Blue Cross Blue Shield of Texas
Monthly Premium
POS
$ubsidy
Silver
- Deductible
- $0 /yr
- Max Out-of-Pocket
- $8,400 /yr
Details
Deductible (per individual) | $0 /yr |
Deductible (per family) | $0 /yr |
Max Out-of-Pocket (per individual) | $8,400 /yr |
Max Out-of-Pocket (per family) | $16,800 /yr |
Drug Deductible (per individual) | Included in Medical |
Drug Deductible (per family) | Included in Medical |
Drug Max Out-of-Pocket (per individual) | Included in Medical |
Drug Max Out-of-Pocket (per family) | Included in Medical |
Plan Type | POS |
Includes Child Dental? | No |
Includes Adult Dental? | No |
Out-of-Pocket Costs
Preventive Care | No Charge |
Primary Care Visit | $115 Copay |
Specialist Visit | $125 Copay |
Emergency Room | $950 and 50% |
Inpatient Facility | $850 Copay per Stay and 50% |
Inpatient Physician | 50% Coinsurance |
Generic Drugs | $40 Copay |
Preferred Brand Drugs | 20% Coinsurance |
Non-preferred Brand Drugs | 45% Coinsurance |
Specialty Drugs | 50% Coinsurance |
Plan Documents
Summary of Benefits and Coverage | SBC doc |
Provider Directory | Doctor lookup |
Drug Formulary List | drug list |
Insurance Carrier Disclaimer
Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
* 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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