Group Hospitalization and Medical Services, Inc.*

Group Hospitalization and Medical Services, Inc.* | BluePreferred PPO HSA Bronze $4,500

  • BluePreferred PPO HSA Bronze $4,500 is an Obamacare health insurance plan offered by Group Hospitalization and Medical Services, Inc.* that is available for individuals and families.

  • This plan is a PPO, meaning you will have the flexibility to visit a preferred healthcare provider network that have preferred rates for in-network physicians. (Read more about PPOs.)

  • This plan is a Bronze metal level plan, which generally has a lower monthly cost but higher annual deductible (and co-pay), and provides basic insurance coverage for people who do not spend regularly on health care (i.e., doctors, prescription drugs, etc.).

  • Deductible amount of $4,500. A deductible is the amount of healthcare costs you will pay on your own each year before the insurance company.

  • Max out-of-pocket of $6,550, which is the most you will pay in a plan year outside of premiums, out-of-network providers and non-essential health benefits.


Ways to Enroll or Learn More

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Plan Summary

Monthly Cost

Plan Name:
BluePreferred PPO HSA Bronze $4,500

Plan ID:
40308VA0240003

Plan Type:
PPO

Deductible:
$4,500

Maximum Out-of-Pocket:
$6,550

Provider Information:

Who is this plan for?

This plan with a lower monthly cost is great for healthy individuals and families who rarely, if ever, visit the doctor or use prescription drugs. The very high deductible on this plan means you will pay a significant amount of money of pocket for medical care and prescriptions before your insurance kicks in. The very high out-of-pocket maximum on this plan means you could be faced with a very expensive medical bill if an emergency happens. Plans with this type of provider network tend to have a more broad provider network.

HealthCare.com is a privately-held internet start-up for healthcare consumers. We’re not the government website.

Highlights


Dental Coverage:
Child

Emergency Room:
$300 Copay after deductible

Retail Drugs:
$75 Copay after deductible

Generic Drugs:
$10 Copay after deductible

Overview


Plan Type:
PPO

Metal Level:
Bronze

Health Spending Account:
Yes

Primary Care Office Visit:
$25 Copay after deductible

Specialist Office Visit:
$50 Copay after deductible

Out of Network Coverage:
Yes

Out of Country Coverage:
Yes

Coverage Details

Preventive Care

Periodic Health Exam
In Network:
No Charge

Out of Network:
No Charge after deductible
Well Baby Care
In Network:
No Charge

Out of Network:
No Charge

Inpatient

Hospital Services
In Network:
$500 Copay per Day

Out of Network:
$600 Copay per Day after deductible
Physician Fee
In Network:
$50 Copay after deductible

Out of Network:
$70 Copay after deductible
Skilled Nursing Facility
In Network:
$100 Copay per Stay

Out of Network:
$200 Copay per Stay after deductible
Mental Health
In Network:
$500 Copay per Day

Out of Network:
$600 Copay per Day after deductible
Substance Abuse
In Network:
$500 Copay per Day

Out of Network:
$600 Copay per Day after deductible
Home Healthcare
In Network:
No Charge after deductible

Out of Network:
$70 Copay after deductible

Outpatient

Surgery
In Network:
$50 Copay after deductible

Out of Network:
$70 Copay after deductible
X-ray and Diagnostics
In Network:
$100 Copay after deductible

Out of Network:
$150 Copay after deductible
Labs
In Network:
$25 Copay after deductible

Out of Network:
$75 Copay after deductible
Facility Fee
In Network:
$300 Copay after deductible

Out of Network:
$400 Copay after deductible
Mental Health
In Network:
$25 Copay after deductible

Out of Network:
$70 Copay after deductible
Substance Abuse
In Network:
$25 Copay after deductible

Out of Network:
$70 Copay after deductible
Rehabilitation Services
In Network:
$50 Copay after deductible

Out of Network:
$70 Copay after deductible

Maternity/Pregnancy

Pre & Postnatal Care
In Network:
No Charge

Out of Network:
$70 Copay after deductible
Labor and Delivery Inpatient Services
In Network:
$500 Copay after deductible

Out of Network:
$600 Copay after deductible

Dental

Accidental Care
In Network:
$300 Copay after deductible

Out of Network:
$300 Copay after deductible
Basic Dental Care (Child)
In Network:
20% Coinsurance after deductible

Out of Network:
40% Coinsurance after deductible
Dental Checkup (Child)
In Network:
No Charge

Out of Network:
20%
Major Dental Care (Child)
In Network:
20% Coinsurance after deductible

Out of Network:
40% Coinsurance after deductible
Orthodontia (Child)
In Network:
50%

Out of Network:
65%

Vision

Eye Exam (Child)
In Network:
No Charge

Out of Network:
Not Covered
Glasses (Child)
In Network:
No Charge

Out of Network:
Not Covered

Additional Coverage

Chiropractic Care
In Network:
$50 Copay after deductible

Out of Network:
$70 Copay after deductible
Habilitation Services
In Network:
$50 Copay after deductible

Out of Network:
$70 Copay after deductible
Rehabilitation Services (Speech)
In Network:
$50 Copay after deductible

Out of Network:
$70 Copay after deductible
Rehabilitation Services (Occupational Therapy)
In Network:
$50 Copay after deductible

Out of Network:
$70 Copay after deductible
Hospice Service
In Network:
No Charge after deductible

Out of Network:
$70 Copay after deductible
Diabetes Care Management
In Network:
$50 Copay after deductible

Out of Network:
$70 Copay after deductible
Durable Medical Equipment
In Network:
$50 Copay after deductible

Out of Network:
$70 Copay after deductible
Nutritional Consuleling
In Network:
No Charge

Out of Network:
No Charge after deductible
Reconstructive Surgery
In Network:
$300 Copay after deductible

Out of Network:
$400 Copay after deductible
Outside US Non-emergency Care
In Network:
$50 Copay after deductible

Out of Network:
$70 Copay after deductible

Doctor Visits

Primary Care Visit
In Network:
$25 Copay after deductible

Out of Network:
$70 Copay after deductible
Specialist Visit
In Network:
$50 Copay after deductible

Out of Network:
$70 Copay after deductible
Other Practitioner Office Visit
In Network:
$50 Copay after deductible

Out of Network:
$70 Copay after deductible
Preventative Care / Screening / Immunization
In Network:
No Charge

Out of Network:
No Charge after deductible

Emergency Room and Urgent Care

Emergency Room Services
In Network:
$300 Copay after deductible

Out of Network:
$300 Copay after deductible
Urgent Care Services
In Network:
$75 Copay after deductible

Out of Network:
$75 Copay after deductible
Ambulance/Transportation Services
In Network:
$50 Copay after deductible

Out of Network:
$50 Copay after deductible

Drugs

Generic Prescription
In Network:
$10 Copay after deductible

Out of Network:
$10 Copay after deductible
Retail Brand Drugs
In Network:
$75 Copay after deductible

Out of Network:
$75 Copay after deductible
Non Retail Brand Drugs
In Network:
$150 Copay after deductible

Out of Network:
$150 Copay after deductible
Specialty Drugs
In Network:
$150 Copay after deductible

Out of Network:
$150 Copay after deductible

Additional Plan Information

Provider Information:

HealthCare.com is a privately owned website, and monthly costs shown above are estimates only. Your monthly premium may change based on the data provided, outside fees, optional benefits or if other factors take effect before your coverage start date. Note that insurance companies reserve the right to change your premium rate and the policy terms at any time. Effective date, benefit amounts and other conditions may apply at the discretion of the insurance carrier you select. Depending on your state of residence, this website may not display all plans available by state. The Obamacare Tax Subsidy Calculator amounts are estimates only and the actual amount of subsidy eligibility may differ. Access to your physician depends on network selected, and networks can change without notice. Contact your health insurance company to confirm your healthcare provider is still available in the network you select.

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