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]
Compare Carriers
Get health insurance quotes, compare plans.
Days Until Open Enrollment
Day(s)
:
Hour(s)
:
Minute(s)
:
Second(s)