Blue Saver Gold for Business - 46944AL0760001 Health Insurance Plan

Blue Cross and Blue Shield of Alabama health insurance plan with the Plan ID 46944AL0760001. The plan is called Blue Saver Gold for Business.

Based on the data of Health Plan Issuer, this plan has an actuarial value of 78.29% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 21.71% of the costs of all covered benefits (according to the Issuer).

Health Insurance Plan ID 46944AL0760001
Health Insurance Plan Year 2025
State Alabama
Health Insurance Issuer Blue Cross and Blue Shield of Alabama
Plan Formulary Description URL Formulary URL
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 46944AL0760001-00
Provider Network(s) TIER-ONE
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 10 Dec 2024 06:32 GMT).

Providers Alabama All US States
All 27649 122611
PCP 3636 5382
Allergy 11 12
OB/GYN 115 170
Dentists 1163 23685
Available Variants of the Health Plan

Standard Off Exchange Plan - 46944AL0760001-00

Standard On Exchange Plan - 46944AL0760001-01

Last Plan Update Date Wed, 18 Sep 2024 00:00 GMT
Last Import Date Tue, 10 Dec 2024 06:32 GMT

Benefits of Blue Saver Gold for Business Health Insurance Plan, 46944AL0760001-00

Benefit Covered In Network Out Of Network
Abortion for Which Public Funding is Prohibited
NO
Accidental Dental
YES

20.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Acupuncture
NO
Allergy Testing
YES

20.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Bariatric Surgery
NO
Basic Dental Care - Adult
NO
Basic Dental Care - Child

Benefits are available up to the end of the month in which the member turns 19.

YES

20.00%

100.00%
Chemotherapy
YES

No Charge

20.00% Coinsurance after deductible
Chiropractic Care

Limit: 15.0 Visit(s) per Year

YES

20.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Cosmetic Surgery
NO
Delivery and All Inpatient Services for Maternity Care
YES

Tier 1: $300.00

Tier 2: $600.00

$1,000.00, 20.00%
Dental Check-Up for Children

Limit: 2.0 Visit(s) per Year

Benefits are available up to the end of the month in which the member turns 19.

YES

No Charge

100.00%
Diabetes Education

Limit: 10.0 Hours per Year

Limited to 2 hours per year after initial 12-month educational period.

YES

20.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Dialysis
YES

No Charge

20.00% Coinsurance after deductible
Durable Medical Equipment
YES

20.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Emergency Room Services
YES

$300.00

$300.00
Emergency Transportation/Ambulance
YES

20.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Eye Glasses for Children

Limit: 1.0 Item(s) per Year

Benefits are available up to the end of the month in which the member turns 19.

YES

20.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Gender Affirming Care

Exclusions: Excludes services deemed as cosmetic.

YES

Tier 1: $300.00

Tier 2: $600.00

$1,000.00, 20.00%
Generic Drugs

Up to a 90-day supply

YES

$10.00

100.00%
Habilitation Services

Limit: 30.0 Visit(s) per Year

Combined maximum visits for Occupational, Physical and Speech therapy

YES

20.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Hearing Aids
NO
Home Health Care Services
YES

No Charge

20.00% Coinsurance after deductible
Hospice Services
YES

No Charge

20.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)
YES

Tier 1: $300.00

Tier 2: $600.00

20.00% Coinsurance after deductible
Infertility Treatment

Exclusions: Excludes Assisted Reproductive Technology

YES

$60.00

20.00% Coinsurance after deductible
Infusion Therapy
YES

No Charge

20.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)
YES

Tier 1: $300.00 Copay per Day

Tier 2: $600.00 Copay per Day

$1000.00 Copay per Stay, 20.00%
Inpatient Physician and Surgical Services
YES

0.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services
YES

No Charge

20.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home Care
NO
Major Dental Care - Adult
NO
Major Dental Care - Child

Benefits are available up to the end of the month in which the member turns 19.

YES

50.00% Coinsurance after deductible

100.00%
Mental/Behavioral Health Inpatient Services
YES

No Charge

20.00%
Mental/Behavioral Health Outpatient Services
YES

$60.00

50.00% Coinsurance after deductible
Non-Preferred Brand Drugs

Up to a 90-day supply

YES

$90.00

100.00%
Nutritional Counseling

Limit: 6.0 Hours per Year

YES

$35.00

20.00% Coinsurance after deductible
Orthodontia - Adult
NO
Orthodontia - Child

Benefits are available up to the end of the month in which the member turns 19.

YES

50.00% Coinsurance after deductible

100.00%
Other Practitioner Office Visit (Nurse, Physician Assistant)
YES

$35.00

20.00% Coinsurance after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
YES

Tier 1: $300.00

Tier 2: $600.00

20.00% Coinsurance after deductible
Outpatient Rehabilitation Services

Limit: 30.0 Visit(s) per Year

Combined maximum visits for Occupational, Physical and Speech therapy

YES

20.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services
YES

0.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Preferred Brand Drugs

Up to a 90-day supply; Covered insulins limited to a $99 member cost share per 30-day supply

YES

$50.00

100.00%
Prenatal and Postnatal Care
YES

0.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Preventive Care/Screening/Immunization
YES

No Charge

100.00%
Primary Care Visit to Treat an Injury or Illness
YES

$35.00

20.00% Coinsurance after deductible
Private-Duty Nursing
NO
Prosthetic Devices
YES

20.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Radiation
YES

No Charge

20.00% Coinsurance after deductible
Reconstructive Surgery
YES

0.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy

Limit: 30.0 Visit(s) per Year

Combined maximum visits for Occupational, Physical and Speech therapy

YES

20.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Rehabilitative Speech Therapy

Limit: 30.0 Visit(s) per Year

Combined maximum visits for Occupational, Physical and Speech therapy

YES

20.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Routine Dental Services (Adult)
NO
Routine Eye Exam (Adult)
NO
Routine Eye Exam for Children

Limit: 1.0 Visit(s) per Year

Benefits are available up to the end of the month in which the member turns 19.

YES

20.00% Coinsurance after deductible

100.00%
Routine Foot Care
NO
Skilled Nursing Facility
NO
Specialist Visit
YES

$60.00

20.00% Coinsurance after deductible
Specialty Drugs

Up to a 30-day supply

YES

$200.00

100.00%
Substance Abuse Disorder Inpatient Services
YES

No Charge

20.00%
Substance Abuse Disorder Outpatient Services
YES

$60.00

50.00% Coinsurance after deductible
Transplant

Limited to Blue Distinction Centers for Transplant Network

YES

0.00% Coinsurance after deductible

100.00%
Treatment for Temporomandibular Joint Disorders

Exclusions: Dental related services

Limited to Phase I services

YES

20.00% Coinsurance after deductible

20.00% Coinsurance after deductible
Urgent Care Centers or Facilities
YES

$35.00

20.00% Coinsurance after deductible
Weight Loss Programs
NO
Well Baby Visits and Care
YES

No Charge

100.00%
X-rays and Diagnostic Imaging
YES

No Charge

20.00% Coinsurance after deductible

Blue Saver Gold for Business Health Insurance Plan Variant 46944AL0760001-00 Attributes

Plan Attribute Value
Begin Primary Care Cost-Sharing After Number Of Visits 0
Begin Primary Care Deductible Coinsurance After Number Of Copays 0
Business Year 2025
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered Yes
CSR Variation Type Standard Gold Off Exchange Plan
Dental Only Plan No
Disease Management Programs Offered Asthma, Heart Disease, Diabetes, Pregnancy
First Tier Utilization 98%
Formulary ID ALF001
Formulary URL URL
HIOS Product ID 46944AL076
HSA/HRA Employer Contribution No
Import Date 2024-09-18 01:01:22
Inpatient Copayment Maximum Days 5
HSA Eligible No
New/Existing Plan Existing
Notice Required for Pregnancy No
Is a Referral Required for Specialist? No
Issuer Actuarial Value 78.29%
Issuer ID 46944
Issuer Marketplace Marketing Name Blue Cross and Blue Shield of Alabama
Market Coverage SHOP (Small Group)
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Gold
Multiple In Network Tiers Yes
National Network Yes
Network ID ALN004
Out of Country Coverage Yes
Out of Country Coverage Description If a PPO provider is used, same benefits as PPO in country apply. If non-PPO provider is used, member is responsible for filing claims and out-of-network benefits would be applicable.
Out of Service Area Coverage Yes
Out of Service Area Coverage Description If a PPO provider is used, same benefits as PPO in service area apply. If non-PPO provier is used, member may be responsible for filing claims and out-of-network benefits would be applicable.
Plan Brochure URL
Plan Effective Date 2025-01-01
Plan ID (Standard Component ID with Variant) 46944AL0760001-00
Plan Marketing Name Blue Saver Gold for Business
Plan Type PPO
Plan Variant Marketing Name Blue Saver Gold for Business
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $600
SBC Scenario, Having a Baby, Deductible $2,500
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $600
SBC Scenario, Having Diabetes, Deductible $200
SBC Scenario, Having Diabetes, Limit $40
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $400
SBC Scenario, Treatment of a Simple Fracture, Deductible $1,900
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Second Tier Utilization 2%
Service Area ID ALS003
Source Name HIOS
Plan ID 46944AL0760001
State Code AL
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person per person not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual Not Applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group per group not applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person per person not applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual Not Applicable
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 20.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group $5000 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person $2500 per person
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $2,500
Combined Medical and Drug EHB Deductible, In Network (Tier 2), Default Coinsurance 20.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 2), Family Per Group $5000 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 2), Family Per Person $2500 per person
Combined Medical and Drug EHB Deductible, In Network (Tier 2), Individual $2,500
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group $5000 per group
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person $2500 per person
Combined Medical and Drug EHB Deductible, Out of Network, Individual $2,500
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group $13500 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $6750 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $6,750
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Family Per Group $13500 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Family Per Person $6750 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Individual $6,750
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person per person not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual Not Applicable
Unique Plan Design Yes
URL for Enrollment Payment URL
URL for Summary of Benefits & Coverage URL
Wellness Program Offered Yes

Copay & Coinsurance of Blue Saver Gold for Business Health Insurance Plan, 46944AL0760001

Drug Tier Pharmacy Type Copay amount Copay option Coinsurance rate Coinsurance option Mail Order

Frequently Asked Questions(FAQ) about Blue Saver Gold for Business, 46944AL0760001 Health Insurance Plan, 46944AL0760001

  • Does Blue Saver Gold for Business Health Insurance Plan, 46944AL0760001 support Mail Ordering?

    Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.

  • Does (46944AL0760001) Health Insurance Plan, Variant (46944AL0760001-00) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma, Heart Disease, Diabetes, Pregnancy

    Does (46944AL0760001) Health Insurance Plan, Variant (46944AL0760001-00) have Out Of Country Coverage?

    Yes. Details: If a PPO provider is used, same benefits as PPO in country apply. If non-PPO provider is used, member is responsible for filing claims and out-of-network benefits would be applicable.

    Does (46944AL0760001) Health Insurance Plan, Variant (46944AL0760001-00) have Out of Service Area Coverage?

    Yes. Details: If a PPO provider is used, same benefits as PPO in service area apply. If non-PPO provier is used, member may be responsible for filing claims and out-of-network benefits would be applicable.

    Does (46944AL0760001) Health Insurance Plan, Variant (46944AL0760001-00) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma, Heart Disease, Diabetes, Pregnancy

    Does Blue Saver Gold for Business Health Insurance Plan, Variant (46944AL0760001-00) offer Disease Management Programs for Asthma?

    Yes, the Blue Saver Gold for Business Health Insurance Plan Variant 46944AL0760001-00 offers Disease Management Program for Asthma.

    Does Blue Saver Gold for Business Health Insurance Plan, Variant (46944AL0760001-00) offer Disease Management Programs for Heart disease?

    Yes, the Blue Saver Gold for Business Health Insurance Plan Variant 46944AL0760001-00 offers Disease Management Program for Heart disease.

    Does Blue Saver Gold for Business Health Insurance Plan, Variant (46944AL0760001-00) offer Disease Management Programs for Diabetes?

    Yes, the Blue Saver Gold for Business Health Insurance Plan Variant 46944AL0760001-00 offers Disease Management Program for Diabetes.

    Does Blue Saver Gold for Business Health Insurance Plan, Variant (46944AL0760001-00) offer Disease Management Programs for Pregnancy?

    Yes, the Blue Saver Gold for Business Health Insurance Plan Variant 46944AL0760001-00 offers Disease Management Program for Pregnancy.

 

Disclaimer: This is based on the import(Date: Tue, 10 Dec 2024 06:32 GMT) of the data from Healthcare Issuers listed by CMS. While we make every effort to ensure that data is accurate, you should assume all results are unvalidated. Source: CMS.gov, HealthPorta HEALTHCARE MRF API