Blue Cross and Blue Shield of Arkansas HSA Blue PPO II Plan Information

Deductible Amount
Individual: $1,500
Family: $3,000

Maximum Lifetime Benefit
$5,000,000 per covered member

Coinsurance
you pay 0% coinsurance after the deductible has been met

Out-of-Pocket Coinsurance
Not applicable

Primary Care Physician Office Visit
You pay 0% coinsurance after deductible has been met

Specialist Office Visit
You pay 0% coinsurance after deductible has been met

Inpatient Services
You pay 0% coinsurance after the deductible has been met

Outpatient Services
You pay 0% coinsurance after the deductible has been met

Emergency Room
You pay 0% after deductible has been met

Children's Preventive Services
You pay 0% coinsurance. Deductible does not apply

Wellness Services
Routine physical exams, gynecological exams, mammograms, PSA tests: You pay 0% after deductible has been met

Psychiatric Conditions/Substance Abuse
Not Covered

Prescription Drugs
You pay 0% after deductible has been met

Hospice
You pay 0% coinsurance after deductible has been met

Optional Riders
Maternity Benefits: You pay 0% after deductible has been met

Other Blue Cross and Blue Shield of Arkansas health insurance plans:

YES NO


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