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Blue Cross Blue Shield (BCBS) HDHP coverage is designed to provide low-premium health insurance plans with higher deductibles.
BCBS HDHP plans often come with a Health Savings Account (HSA) option, which allows you to set aside pre-tax dollars for medical expenses.
The deductible for BCBS HDHP plans can range from $1,400 to $6,900 for individuals and $2,800 to $13,800 for families.
HSAs can be used to pay for qualified medical expenses, and any unused funds can be carried over to future years.
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High-Deductible Plan Pros and Cons
High-deductible plans can be a great option for those who need health insurance mostly for preventive care, like annual checkups with your doctor.
Lower premiums are a major advantage of high-deductible health plans (HDHPs), allowing you to pay less for health coverage each month.
You can also save on medical expenses with a tax-free spending account option when paired with a Health Savings Account (HSA).
However, you'll pay more toward your deductible before your healthcare plan begins paying for covered costs.
With an HDHP, you may pay more out of pocket for non-preventive healthcare until you reach your plan's yearly deductible amount.
If you have a health savings account (HSA), you can use it to help pay for eligible medical expenses, and the money deposited into an HSA is tax-free.
Here are the key pros and cons of high-deductible health plans to consider:
Key Features
The BCBS HDHP offers 100% coverage of medical preventive services, including preventive prescriptions, which are not subject to the deductible. This means you'll have access to essential health services without breaking the bank.
To estimate costs for non-preventive health care services, use the BCBS "Find a Doctor" tool. This tool will help you find providers and estimate costs.
One of the key benefits of the HDHP is its lower premium compared to the MIT BCBS PPO+ Health Plan. However, it comes with a higher deductible, which means you'll pay more out-of-pocket for non-preventive healthcare until you reach your plan's yearly deductible amount.
Here are the IRS-defined deductibles for the HDHP:
The HDHP also offers a tax-free spending account option through a Health Savings Account (HSA), which can help you save on medical expenses.
Benefits of This Plan
This plan offers comprehensive coverage for medical expenses, including 100% coverage of preventive services, such as annual checkups and vaccinations. The plan also covers preventive prescriptions, but may have an associated cost if another health issue is treated at the same appointment.
The plan has a lower premium compared to the MIT BCBS PPO+ Health Plan, which means you'll pay less for health coverage each month. However, you'll need to pay more out-of-pocket for non-preventive healthcare services until you reach your plan's yearly deductible amount.
You can use the BCBS "Find a Doctor" tool to estimate costs for non-preventive healthcare services and find providers. This tool will help you get a better understanding of what you'll be paying out-of-pocket.
The plan also offers a tax-free spending account option, which can be paired with a Health Savings Account (HSA) to help you save on medical expenses. This is especially beneficial if you have a high-deductible health plan and want to save for eligible medical expenses.
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Here are some of the benefits of this plan:
- BCBS TrueCare 360 Advocacy and Care Management: Dedicated Blue Care Managers and Service Advocates will help you navigate the complex healthcare system, find resources in your community, and coordinate care.
- BCBS Virtual Primary Care: You'll get $0 cost for virtual primary care and mental health visits offered via chat, text, phone, and video with select providers.
- Expanded and updated fertility benefits: The plan now includes a new egg cryopreservation benefit and updates to frozen embryo requirements.
- Enhanced gender-affirming care benefits: The plan has been updated to include more comprehensive care for individuals seeking gender-affirming services.
The plan's deductible level varies depending on the plan you choose, with some plans having a low deductible and others having a higher deductible. For example, the Standard Silver CDHP Reflective plan has a low deductible, while the Catastrophic plan has a higher deductible.
Pharmacy Options
You've got a few options when it comes to pharmacies. CVS Caremark's network includes most retail chain pharmacies, such as CVS, Walmart, and Target.
You can easily find in-network pharmacies by logging in to Caremark.com or the Caremark app.
Network and Providers
You'll have access to a nationwide network through the BCBS HDHP, which doesn't require a Primary Care Provider (PCP).
This plan uses the Anthem Blue Access PPO network in Indiana, and the Anthem National PPO (BlueCard PPO) network in other states, giving you a wide range of in-network providers to choose from.
For another approach, see: Tufts Health Plan Ppo
Nationwide Network Access
You'll have access to a nationwide network with the BCBS HDHP, which means you can see a doctor or get medical care no matter where you are in the US.
This plan doesn't require you to have a Primary Care Provider (PCP), giving you more flexibility in choosing your healthcare.
The BCBS HDHP uses the Anthem National PPO (BlueCard PPO) network in most states outside of Indiana, allowing you to see in-network providers even when you're traveling.
You can find in-network providers by logging in to Anthem.com or using the Sydney Health app and searching with the Find Care tool.
The Anthem Blue Cross Blue Shield Global Core network is also available for international care, giving you coverage when you're abroad.
Additional reading: Difference between Hmo Pos and Ppo Plan
Vermont Preferred
Vermont Preferred plans offer a unique combination of benefits, including zero-dollar office visits for primary care, mental health, or substance use disorder treatment. You can have up to 4-8-12 of these visits per year, depending on your plan.
Related reading: Bcbs Online Visit
The Vermont Preferred plans also include four zero-dollar office visits per member for chronic care specialist visits for members with certain conditions. This can be a huge help if you're managing a chronic illness.
The plans are divided into different levels, including Gold, Silver Reflective, Silver, and Bronze. Each level has its own deductible level, which ranges from low to high.
Here's a breakdown of the plans:
These plans are a great option if you're looking for a more affordable way to access healthcare services.
Vermont Select
Vermont Select plans offer complete coverage after the deductible and out-of-pocket limit is met for the plan year, allowing you to save money in a Health Savings Account (HSA).
Each Vermont Select plan can be paired with an HSA, providing a convenient way to save for medical expenses.
Here are the Vermont Select plans available, each with its own deductible level:
Frequently Asked Questions
What does blue shield HDHP mean?
Blue Shield HDHP refers to a High Deductible Health Plan, a type of insurance with lower premiums but higher out-of-pocket costs before insurance coverage kicks in. This plan is designed for individuals who want to save on premiums but are willing to take on more financial responsibility for their healthcare expenses.
What is the difference between BCBS HDHP and PPO?
BCBS HDHP and PPO plans differ in premium and deductible costs: HDHPs have lower premiums but higher deductibles, while PPOs have higher premiums but lower deductibles
What does HDHP insurance cover?
HDHP insurance covers major medical expenses and preventive care at 100%, with the option to use an HSA for out-of-pocket expenses.
What is the BCBS HDHP plan?
The BCBS HDHP plan is a high-deductible health plan that requires you to pay full costs for services until you meet your deductible, except for preventive care services which are fully covered. After meeting your deductible, you'll only pay a small percentage of costs through co-insurance.
Sources
- https://www.anthem.com/individual-and-family/insurance-basics/health-insurance/what-is-a-high-deductible-health-plan
- https://hr.mit.edu/benefits/health/hdhp
- https://www.horizonblue.com/rwjbarnabashealth/plans/medical-plans/high-deductible-health-plan-rwjbh-bhealthy-care
- https://hr.iu.edu/benefits/medical-plans/hdhp.html
- https://www.bluecrossvt.org/our-plans/individuals-and-families/plans-individuals-and-families
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