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Bcbs Tx Com

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All plans from Blue Cross and Blue Shield of ... - BCBSTX

All plans from Blue Cross and Blue Shield of ... - BCBSTX

www.bcbstx.com

Gold Blue Advantage Gold HMO SMBlue Advantage Plus Gold MyBlue Health GoldSM in collaboration with Sanitas USA* 206 2072 203 403 Individual Deductible 3 $750 $0 $750 $1,100 Coinsurance 40% 40% 30%4 30% Out-of-Pocket Maximum (includes deductible) 3 $8,550 $8,550 $8,550 $8,550 Primary Care Office Visit $30 copay $20 copay $15 copay $0 / $205 Specialist …

  Bcbstx

All plans from Blue Cross and Blue Shield of Texas (BCBSTX ...

All plans from Blue Cross and Blue Shield of Texas (BCBSTX ...

www.bcbstx.com

Bronze Blue Advantage Bronze HMOSM MyBlue Health BronzeSM* 204 301 302 2 402 Individual Deductible 3 $6,000 $8,700 $7,000 $7,400 Coinsurance 50% 40% 0% 50% Out-of-Pocket Maximum (includes deductible) 3 $8,700 $8,700 $7,000 $8,700 Primary Care Office Visit $45 copay 0% 0% $0 / $1005 Specialist Office Visit 50% 40% 0% 50% Mental Illness Treatment …

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