Blue Cross and Blue Shield of Texas Foundation Hospital Care Plan I Plan Information
Coverage Level 80%
Physician/Hospital Network BlueChoice or BlueCard Preferred Provider Organization
Lifetime Benefit $2 Million
Individual Out-of-Pocket Expense Deductible plus $5,000
Office Visit Co-pay Not Applicable
Family Out-of-Pocket Expense Deductible plus $15,000
Outpatient Physician Medical Services Not Covered
Outpatient Physician Surgical Services Not Covered
Preventative Care Not Covered
Childhood Immunizations Not Covered
Inpatient Physician Medical/Surgical Services Not Covered
Outpatient Hospital Services Not Covered
Outpatient Hospital Diagnostic Testing Not Covered
Inpatient Hospital Services and Diagnostic Testing Deductible and Coinsurance
Outpatient Prescription Drugs Not Covered
Other Blue Cross and Blue Shield of Texas health insurance plans:
