BlueCross BlueShield of AZ AdvanceHealth Silver 6 Plan
This is a BlueCross BlueShield Marketplace plan. Marketplace plans include an annual physical and many preventative services for free, include prescription benefits, cover maternity, and mental health visits. They also cover preexisting conditions without a waiting period. Based on your household size, zip code and income; you may receive subsidies to pay for a portion of your premium. This is an HMO plan which means that you must use in-network doctors and hospitals, except for emergencies. They have a very large network of doctors to choose from, be aware that you do not need a referral to see a specialist.
Carrier
BlueCross of Arizona
Plan Year
2025
Plan State
Arizona
Deductible
$600
Maximum Out of Pocket
$600
Doctor Visits
Doctor visit costs is the amount you pay for each visit, whether it's to a Primary Care Physician, a specialist, or for mental health services. Many plans have a copay for these services or a fixed amount that you pay for each visit. Primary care visits typically have lower copays, while specialty care may come with higher costs. Virtual visits are a convenient option, often with reduced copays for primary care or mental health services, but may have additional charges for specialty or urgent care. These copays usually apply before your deductible is met, meaning you'll pay them upfront regardless of if you've met your deductible or not. Some high deductible plans and HSA plans may require you to pay full price for your office visits until your deductible is met before your health plan pays a portion of your care. Be sure to review your plan to understand what is covered and any exceptions for virtual or in-person visits.
Primary Care Visit
No charge first 4 visits, then no charge after deductible
Specialty Care Visit
No Charge after deductible
Mental Health Visit
No charge after deductible
Virtual Visits*
$5 copay
*Virtual visits may only cover specific types of services like primary care visits or mental health visits. Please check the full summary of benefits or with your local agent to verify coverage.
Emergency and Urgently Needed Services
Emergency and urgently needed services is medical care that is required immediately due to a life-threatening situation or when delaying care could result in serious harm. Emergency services encompass situations like severe injuries, heart attacks, or sudden illnesses that demand immediate attention. Urgently needed services involve medical conditions that require prompt care to avoid complications, even though they might not be immediately life-threatening. Health insurance plans typically cover Emergency room and ambulance services, even if the provider is out of network, ensuring that individuals receive essential care regardless of the circumstances.
Urgent Care Visit
No charge after deductible
Emergency Room Visit
No charge after deductible
Ground Ambulance
No charge after deductible
Prescription Coverage
Prescription medications are prescribed by healthcare providers to treat various medical conditions. They play a crucial role in managing health, and their cost can vary significantly based on factors such as the drug's brand or generic status, dosage, and insurance coverage. If you're looking for information about the cost of your prescription drugs and how they are covered by your insurance plan, a local agent at Utah Avenue Insurance can provide assistance and help you understand the specifics of your medication coverage.
Preferred Generic
No charge
Extra Benefits for Children
Many health insurance plans offer extra benefits for kids under 18 to ensure their well-being. These benefits often include coverage for pediatric services such as well-child visits, immunizations, vision and dental care, and preventive screenings. Additionally, some plans might provide access to specialized pediatric care and therapies, ensuring that children receive comprehensive healthcare tailored to their developmental needs. It's important to review your insurance policy to understand the specific extra benefits available for kids and their coverage details.
Children's Eye Exam
No Charge
Children's Glasses
No charge after deductible
Children's Dental Check Up
No charge after deductible
Full Summary of Benefits and Helpful Links
Official documents, such as your insurance policy or Summary of Benefits and Coverage (SBC), outline the details of your coverage, including deductibles, copayments, and covered services. Provider links, often available through your insurance company's website, offer directories of in-network healthcare professionals and facilities, helping you find the right doctors and hospitals that are covered by your plan. Utilizing these resources can empower you to make informed healthcare decisions and effectively navigate your insurance coverage.
Helpful Links
Schedule a consultation with a local health insurance agent
We're here to assist you with your health insurance needs, whether you'd prefer to meet in person, virtually, or over the phone. Our team can guide you through health insurance options both on and off the Marketplace, as well as Medicare Advantage and supplements, dental, vision, life, and accident plans. Thank you for trusting us as your advocate. Best of all, our services are always at no cost to you!
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Please note that the costs and copays mentioned are subject to change based on the terms set by your health insurance provider. Utah Avenue Insurance strives to provide accurate information, but we cannot guarantee the exact costs or benefits outlined in your specific plan. It is important to review your policy details directly with your insurance company. Utah Avenue Insurance is not liable for any discrepancies or changes in coverage, copays, or other plan details.