|
|
|
BluePreferred
Basic
$10,000 |
In-Network |
Out-Of-Network |
 |
Annual
Deductible
|
Individual:
$10,000
Family:
$20,000
|
Individual:
$20,000
Family:
$40,000
|
|
|
Annual
Out-Of-Pocket
Limit
|
$4,000
per
person
(Deductible
not
Included) |
$8,000
per
person
(Deductible
not
Included) |
|
|
Lifetime
Maximum
|
$3,000,000 |
$3,000,000 |
|
|
Office
Visits
|
PCP
$40/Specialist
20% |
50% |
|
|
Prescription
Drugs
|
$30
Generic
Up
to
$125
Brand |
After
submitting
a
claim,
you
will
be
reimbursed
for
amounts
above
the
$125
maximum,
up
to
the
BCBSAZ
allowed
amount
per
prescription. |
|
|
Laboratory
and
Radiology
|
20% |
50% |
|
|
Annual
Physical
Exam
|
20%
(deductible
waived) |
Not
Covered |
|
|
Annual
OB-GYN
Exam
|
20%
(deductible
waived) |
Not
Covered |
|
|
Prenatal
/
Postnatal
Maternity
|
Not
Applicable |
Not
Applicable |
|
|
Well
Baby
Care
|
20%
(deductible
waived) |
Not
Covered |
|
|
Outpatient
Surgery
|
20% |
50% |
|
|
Emergency
Room
|
20%
plus
$150
(waived
if
admitted) |
20%
plus
$150
(waived
if
admitted) |
|
|
Ambulance
|
20%
(Deductible
Waived) |
20%
(Deductible
Waived) |
|
|
Home
Health
Care
|
20%
(Up
to 3
visits
of 2
hours
or
less
per
day) |
50%
(Up
to 3
visits
of 2
hours
or
less
per
day) |
|
|
Mental
Health
Services
|
See
benefits
contract |
See
benefits
contract |
|
|
Chiropractic
Care
|
20%
(deductible
waived) |
50%
(deductible
waived) |
|
|
Acupuncture
/
Acupressure
|
Not
Covered |
Not
Covered |
|
|
Inpatient
Co-payment
|
20% |
50% |
|
|
Maternity
Care |
Not
Covered |
Not
Covered
|
|
|
Inpatient
Mental
Health |
20%
(2
admissions,
up
to a
combined
total
of
30
days.
$25,000
maximum
benefit) |
50%
(2
admissions,
up
to a
combined
total
of
30
days.
$25,000
maximum
benefit
per
person) |
|
|
Chemical
Dependency
|
See
benefits
contract |
See
benefits
contract |
|
|
QUOTE
APPLY ONLINE
DOWNLOAD APPLICATION
DOCTOR SEARCH
PLAN
BENEFITS PDF
EXCLUSIONS |
| |
|
About
Blue
Cross
Blue
Shield
of
Arizona
Blue Cross Blue Shield of Arizona, an independent licensee of the Blue Cross Blue Shield Association, is a local not-for profit health insurance company headquartered in Phoenix. Founded in 1939, the company has more than 1,500 dedicated employees throughout its Phoenix, Tucson, Tempe and Flagstaff offices.
The company provides health insurance products, services or networks to more than 1.1 million individuals, making it the largest locally based insurance company in Arizona.
Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
As an active supporter of the community, Blue Cross Blue Shield supports more than 200 organizations statewide through volunteering and contributions.
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