Hmo Louisiana – Precision Blue Copay Pcp 75 55 2000 Standardized Br

Insurance Plan

Precision Blue Copay (PCP) 75/55 $2000 Standardized (BR)

Type:POS
Coverage:Individual

Summary

Plan Info & Network Details

Plan ID:19636LA0610011

State:LA

Metal Level:Gold

HSA Eligible:No

Out-of-Network Coverage:Yes

Out-of-Country Coverage Description:Emergency and non-emergency coverage subject to Blue Card Worldwide rules.

Out-of-Service Area Description:Coverage available for covered benefits
National Network:Yes

Cost Sharing Details

Out of Pocket Maximum

Individual

$8300 per person

Family (Group)

$16600 per group

Deductible

Individual

$2000 per person

Family (Group)

$4000 per group

Coinsurance

Rate

25.00%

Out of Network Costs

Maximum

Individual

$24900 per person

Family (Group)

$49800 per group

Deductible

Individual

$6000 per person

Family (Group)

$12000 per group

Plan Features & Resources

The Plan Features & Resources section highlights important aspects of a health plan, such as specific options available to members, like the Child-Only Option, which enables enrollment for both adults and children separately. It also provides Additional Resources like downloadable brochures and links to the Premium Payment Website for managing payments. This section is designed to give users access to key features and helpful documents related to their plan.

Plan Features

Wellness Program: No
Disease Management Programs: Asthma, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Pregnancy
Notice Pregnancy : No
Referral Specialist : No
Child-Only Option: Allows Adult and Child-Only

Covered Services

Covered Services outlines the different types of services and areas covered by your insurance plan. This includes the Dental-Only Plan, which limits coverage to dental services only, excluding other health-related services. Out-of-Country Coverage refers to services provided outside the country, generally covered at an out-of-network level. Out-of-Service Area Coverage applies to services received outside of the designated service area, also typically covered at the out-of-network rate. Lastly, IN Coverage is specific to a certain state (for example, Indiana), indicating that coverage applies to services or providers within that state. These categories help define the scope of your plan's coverage and the areas where services are covered.

Cost Sharing for Common Conditions

Cost sharing for common conditions generally refers to the portion of health care costs that a person is responsible for under their health insurance plan. This includes different components like the deductible, copayment, coinsurance, and limits for specific medical conditions or treatments. The deductible is the amount a patient must pay out-of-pocket before their insurance begins covering the cost of care. Copayments are fixed amounts that the insured pays for medical services or prescriptions, while coinsurance is the percentage of costs that the insured must pay after the deductible has been met. Limits define the maximum amount a person will have to pay for a specific treatment or condition under their health insurance plan. Understanding these elements helps individuals plan for potential out-of-pocket expenses when managing common health conditions, ensuring they know what to expect financially.

Having a Baby

Deductible:$2,000
Copayment:$70
Coinsurance:$1,640
Limit:$60

Having Diabetes

Deductible:$140
Copayment:$1,200
Coinsurance:$0
Limit:$60

Having a Simple Fracture

Deductible:$2,000
Copayment:$220
Coinsurance:$10
Limit:$0

Plan Attributes

The Plan Attributes section provides an overview of the various features and details that define the structure of your insurance plan. This includes key attributes such as coverage limits, specific benefits, and services offered under the plan. It highlights important factors like the type of care covered, out-of-network options, and any additional resources available. Understanding these attributes will help you get a clear picture of your plan’s coverage and how it fits your healthcare needs.

No plan attributes available.

Service Area Coverage

The Service Area Coverage section outlines the geographical areas where your health plan provides coverage. It includes details on which counties or ZIP codes are covered, helping you to understand the locations where you can access healthcare services under your plan. This coverage may vary depending on whether the area is serviced by an in-network provider. Each county or ZIP code listed shows whether it is covered by the plan and any specific limitations or conditions tied to the location. Ensure your area is covered for full access to the plan's benefits.

No service area information available.

Hospitals That Accept This Insurance

The Hospitals That Accept This Insurance section provides a list of hospitals that are covered under the insurance plan you are currently reviewing. It includes important details such as the name of the hospital, the number of providers and beds available, the specialties offered, and the hospital's location. This section helps you find healthcare facilities that are included in your insurance network, ensuring that you receive the benefits your plan offers while seeking care. Data is available till 2025.

No hospitals found for this insurance plan.

Providers That Accept This Insurance

The Providers That Accept This Insurance section lists healthcare professionals who accept the insurance plan you are viewing. It provides details about each provider, such as their name, specialty, years of experience, and ratings. This information helps you find doctors, dentists, and other medical professionals who are part of the insurance network, ensuring that you receive covered care within your insurance plan's terms. Data is available till 2025.

No doctors available.