AZ Blue AdvanceHealth Bronze Neighborhood (4 Free PCP Visits)

Blue Cross Blue Shield of Arizona

Expanded BronzeHSA eligible

Ind. deductible: $10,150
Family deductible: $10,150
Ind. OOP max: $10,150
Family OOP max: $10,150

Other cost-sharing reduction variants for this plan:

Limited Cost Sharing Plan Variation Standard Bronze Off Exchange Plan Zero Cost Sharing Plan Variation

Monthly premiums by age

Age	Individual	Individual + tobacco
21	$619	—
30	$702	—
40	$791	—
50	$1,105	—
60	$1,679	—

Live premium estimate

Benefits & cost sharing

Primary Care

Benefit	In-network
Preventive Care/Screening/Immunization	No charge
Primary Care Visit to Treat an Injury or Illness	$0.00

Specialist

Benefit	In-network
Specialist Visit	No Charge after deductible

Hospital

Benefit	In-network
Emergency Room Services	No Charge after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	No Charge after deductible
Outpatient Surgery Physician/Surgical Services	No Charge after deductible
Urgent Care Centers or Facilities	No Charge after deductible

Pharmacy

Benefit	In-network
Generic Drugs	$0.00
Non-Preferred Brand Drugs	No Charge after deductible
Preferred Brand Drugs	$0.00
Specialty Drugs	No Charge after deductible

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	No Charge after deductible
Mental/Behavioral Health Outpatient Services	No Charge after deductible

Other

Benefit	In-network
Abortion for Which Public Funding is Prohibited	Not covered
Accidental Dental	No Charge after deductible
Acupuncture	Not covered
Allergy Testing	No Charge after deductible
Bariatric Surgery	No Charge after deductible
Basic Dental Care - Adult	Not covered
Basic Dental Care - Child	No Charge after deductible
Chemotherapy	No Charge after deductible
Chiropractic Care	$0.00
Cosmetic Surgery	Not covered
Delivery and All Inpatient Services for Maternity Care	No Charge after deductible
Dental Check-Up for Children	No Charge after deductible
Diabetes Education	No charge
Dialysis	$0.00
Durable Medical Equipment	$0.00
Emergency Transportation/Ambulance	$0.00
Eye Glasses for Children	$0.00
Habilitation Services	No Charge after deductible
Hearing Aids	No Charge after deductible
Home Health Care Services	$0.00
Hospice Services	No Charge after deductible
Imaging (CT/PET Scans, MRIs)	No Charge after deductible
Infertility Treatment	Not covered
Infusion Therapy	$0.00
Inpatient Physician and Surgical Services	$0.00
Laboratory Outpatient and Professional Services	No Charge after deductible
Long-Term/Custodial Nursing Home Care	Not covered
Major Dental Care - Adult	Not covered
Major Dental Care - Child	No Charge after deductible
Nutritional Counseling	No charge
Orthodontia - Adult	Not covered
Orthodontia - Child	No Charge after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)	No Charge after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	No Charge after deductible
Outpatient Rehabilitation Services	No Charge after deductible
Prenatal and Postnatal Care	$0.00
Private-Duty Nursing	No Charge after deductible
Prosthetic Devices	No Charge after deductible
Radiation	No Charge after deductible
Reconstructive Surgery	No Charge after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	No Charge after deductible
Rehabilitative Speech Therapy	No Charge after deductible
Routine Dental Services (Adult)	Not covered
Routine Eye Exam (Adult)	Not covered
Routine Eye Exam for Children	No charge
Routine Foot Care	Not covered
Skilled Nursing Facility	No Charge after deductible
Substance Abuse Disorder Inpatient Services	$0.00
Substance Abuse Disorder Outpatient Services	No Charge after deductible
Transplant	$0.00
Treatment for Temporomandibular Joint Disorders	No Charge after deductible
Weight Loss Programs	Not covered
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	$0.00

Plan rules

Service area

This plan covers 1 geographic area.