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Blue Cross Blue Shield of Arizona

Our Rating: ★★★★☆

Important Plan Availability Information

Blue Cross Blue Shield of Arizona individual and family plans are not available for sale to residents of Maricopa and Pima Counties.

Residents in Maricopa and Pima Counties should check out other insurance carriers.

EverydayHealth

EverydayHealth HMO is the most popular BCBSAZ plan for individuals and families. The EverydayHealth plan offers copays for most routine care with doctors in the network. Surgeries and other major health care apply a deductible and coinsurance.
EverydayHealth may be right for you and your family if you:

    • Want low out-of-pocket costs for doctor visits and prescription drugs
    • Need financial protection in case you have an emergency or a major medical issue
    • Want broad coverage, but don’t want to pay too much each month for your premium

 

EverydayHealth 1500 EverydayHealth 4000 EverydayHealth 6000
Calendar Year Deductible

$1,500/member and $3,000/family

$4,000/member and $8,000/family

$6,500/member and $13,000/family

Metal Level Gold ($$$) Silver ($$) Bronze ($)
Coinsurance  20% after deductible 20% after deductible 10% after deductible
Out-of-Pocket Limit

$5,500/member and

$11,000/family

$6,650/member and $13,300/family

$7,350/member and $14,700/family

Primary Care Physician/Pediatrician  $10 copay $15 copay $30 copay
Specialist  $40 copay $40 copay $100 copay
UrgentCare Visit $60 copay $60 copay $100 copay
PreventiveServices No charge, deductible waived No charge, deductible waived No charge, deductible waived
Prescription Drug Deductible for Level 2 and 3 drugs $300/member $450/member $650/member
Prescription Drugs

Level 1: $10 copay

Level 2: $50 copay after deductible

Level 3: 40% after deductible

Level 1: $15 copay

Level 2: $60 copay after deductible

Level 3: 40% after deductible

Level 1: $35 copay

Level 2: $100 copay after deductible

Level 3: 40% after deductible

Specialty Drugs 45%, deductible waived 50%, deductible waived 50%, deductible waived
Surgery (Inpatient/Outpatient) 20% after deductible 20% after deductible 10% after deductible
Emergency Room Visit 20% after deductible 20% after deductible 10% after deductible
Ambulance 20%, deductible waived 20%, deductible waived 10%, deductible waived
Maternity $40 copay for all services included in the physician’s global delivery charge, and 20% after deductible for all other services $40 copay for all services included in the physician’s global delivery charge, and 20% after deductible for all other services $100 copay for all services  included in the physician’s  globa ldelivery charge, and 10% after deductible for all other services
Pediatric Routine Vision 1 exam per year $10 copay $15 copay $30 copay
Pediatric Dental

Diagnostic & Preventive: No charge

Restorative & Orthodontia: 50% after deductible

Diagnostic & Preventive: No charge

Restorative & Orthodontia: 50% after deductible

Diagnostic & Preventive: No charge

Restorative & Orthodontia: 50% after deductible

Portfolio HSA

A low premium plan eligible for use with a Health Savings Account (HSA) from a qualified financial institution. This plan provides flexibility on how your healthcare dollars are spent while offering potential tax savings when paired with an HSA. Many preventive services are covered at no out-of-pocket cost to you.

Portfolio 6650
Calendar Year Deductible The amount you pay for covered services before the plan begins to pay. After you meet the deductible you pay coinsurance. $6,650/member and $13,300/family
Metal Level Bronze ($)
Coinsurance Percentage paid for certain covered services after meeting the deductible, unless a different coinsurance applies. No charge after deductible
Out-of-Pocket Limit The most you will pay in a calendar year for all covered services. This does not include premiums, precertification charges, or balance bills. $6,650/member and $13,300/family
Primary Care Physician/Pediatrician Includes internal medicine, family practice, general practice, and pediatricians. All other physicians are specialists. No charge after deductible
Specialist A physician or other health care professional who practices in a specific area other than those practiced by primary care providers. No charge after deductible
Urgent Care Visit Care for an illness, injury, or condition serious enough that a reasonable person would seek care right away, but not so severe as to require emergency room care. No charge after deductible
Preventive Services Performed for screening purposes before any signs or symptoms of a condition or disease appear. The physician determines whether a service is considered preventive. No charge, deductible waived
Prescription and Specialty Drugs No charge after deductible
Surgery (Inpatient/Outpatient) No charge after deductible
Emergency Room Visit No charge after deductible
Ambulance No charge after deductible
Maternity No charge after deductible
Pediatric Routine Vision 1 exam per year No charge after deductible
Pediatric Dental 2 check-ups and cleanings per year. Services covered for members under age 19. See page 9 for more details. Diagnostic & Preventive: No charge after deductible

Restorative & Orthodontia: No charge after deductible

SimpleHealth

Available only to people under age 30 or who receive an exemption from the individual mandate through the Health Insurance Marketplace. Your first three office visits to a primary care doctor in your network apply a copay.

 

SimpleHealth

Calendar Year Deductible The amount you pay for covered services before the plan begins to pay. Copays are separate from the deductible and do not count towards the deductible.

$7,350/member and $14,700/family

Metal Level

Catastrophic ($)

Out-of-Pocket Limit The most you will pay in a calendar year for all covered services. This does not include premiums, precertification charges, or balance bills.

$7,350/member and $14,700/family

Primary Care Physician/Pediatrician Includes internal medicine, family practice, general practice, and pediatricians. All other physicians are specialists.

$20 for first three office visits then no charge after deductible

Specialist A physician or other health care professional who practices in a specific area other than those practiced by primary care providers.

No charge after deductible

Urgent Care Visit Care for an illness, injury, or condition serious enough that a reasonable person would seek care right away, but not so severe as to require emergency room care.

No charge after deductible

Preventive Services Performed for screening purposes before any signs or symptoms of a condition or disease appear. The physician determines whether a service is considered preventive.

No charge, deductible waived

Prescription and Specialty Drugs

No charge after deductible

Surgery (Inpatient/Outpatient)

No charge after deductible

Emergency Room Visit

No charge after deductible

Ambulance

No charge after deductible

Maternity

No charge after deductible

Pediatric Routine Vision 1 exam per year

No charge after deductible

Pediatric Dental 2 check-ups and cleanings per year. Services covered for members under age 19. See page 9 for more details.

Diagnostic & Preventive: No charge Restorative & Orthodontia: No charge after deductible

Contact Us
Phone: (312) 726-6565
Email: [email protected]

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