BlueCross B19E $60 PCP Copay + $0 virtual care from Teladoc Health®

BlueCross BlueShield of Tennessee · 2026 plan year

Expanded BronzeHSA eligible
Ind. medical deductible
$0
Rx deductible (separate)
$3,800
Family deductible
$0
Ind. OOP max
$10,600
Family OOP max
$21,200

This plan sets a separate deductible for prescription drugs. The medical deductible shown does not cover prescriptions; they have their own.

Compare with other Expanded Bronze plans in TN

Side by side: deductibles, out-of-pocket limits and copays.

More BlueCross BlueShield of Tennessee plans in TN

Monthly premiums by age

Rating Area 4

AgeIndividualIndividual + tobacco
Under 15$439$439
21$574$660
30$651$749
40$733$843
50$1,025$1,179
60$1,558$1,791
64 and over$1,722$1,980

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$60.00

Specialist

BenefitIn-network
Specialist Visit$130.00

Hospital

BenefitIn-network
Emergency Room Services$2,500.00
Inpatient Hospital Services (e.g., Hospital Stay)$3000.00 Copay per Day
Outpatient Surgery Physician/Surgical Services50.00%
Urgent Care Centers or Facilities$130.00

Pharmacy

BenefitIn-network
Generic Drugs$35.00
Non-Preferred Brand Drugs$250.00
Preferred Brand Drugs$195.00
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services$3000.00 Copay per Day
Mental/Behavioral Health Outpatient Services$60.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Accidental Dental50.00%
AcupunctureNot covered
Allergy Testing$40.00
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - Child50.00%
Chemotherapy50.00%
Chiropractic Care50.00%
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care$3,000.00
Dental Check-Up for ChildrenNo charge
Diabetes Education50.00%
Dialysis50.00%
Durable Medical Equipment50.00%
Emergency Transportation/Ambulance50.00%
Eye Glasses for ChildrenNo charge
Gender Affirming Care50.00%
Habilitation Services50.00%
Hearing Aids50.00%
Home Health Care Services50.00%
Hospice Services50.00%
Imaging (CT/PET Scans, MRIs)50.00%
Infertility TreatmentNot covered
Infusion Therapy50.00%
Inpatient Physician and Surgical ServicesNo charge
Laboratory Outpatient and Professional Services$40.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - Child50.00%
Nutritional Counseling50.00%
Orthodontia - AdultNot covered
Orthodontia - Child50.00%
Other Practitioner Office Visit (Nurse, Physician Assistant)$60.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)50.00%
Outpatient Rehabilitation Services50.00%
Prenatal and Postnatal Care$60.00
Private-Duty NursingNot covered
Prosthetic Devices50.00%
Radiation50.00%
Reconstructive Surgery50.00%
Rehabilitative Occupational and Rehabilitative Physical Therapy50.00%
Rehabilitative Speech Therapy50.00%
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility$3000.00 Copay per Day
Substance Abuse Disorder Inpatient Services$3000.00 Copay per Day
Substance Abuse Disorder Outpatient Services$60.00
Transplant50.00%
Treatment for Temporomandibular Joint Disorders50.00%
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging$40.00

Plan rules

Service area

This plan covers 9 geographic areas.

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