Precision Blue 90/70 $9900 with 2 $0 PCP Virtual Visits (M) HSA Eligible

HMO Louisiana · 2026 plan year

BronzeHSA eligible
Ind. deductible
$9,900
Family deductible
$21,200
Ind. OOP max
$10,600
Family OOP max
$21,200

Compare with other Bronze plans in LA

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

More HMO Louisiana plans in LA

Monthly premiums by age

Rating Area 7

AgeIndividualIndividual + tobacco
Under 15$283$283
21$371$426
30$421$484
40$474$545
50$662$761
60$1,006$1,156
64 and over$1,112$1,278

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness10.00% Coinsurance after deductible

Specialist

BenefitIn-network
Specialist Visit10.00% Coinsurance after deductible

Hospital

BenefitIn-network
Emergency Room Services10.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)10.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services10.00% Coinsurance after deductible
Urgent Care Centers or Facilities10.00% Coinsurance after deductible

Pharmacy

BenefitIn-network
Generic Drugs10.00% Coinsurance after deductible
Non-Preferred Brand Drugs30.00% Coinsurance after deductible
Preferred Brand Drugs30.00% Coinsurance after deductible
Prescription Drugs Other10.00% Coinsurance after deductible
Specialty Drugs30.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services10.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services10.00% Coinsurance after deductible

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental10.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing10.00% Coinsurance after deductible
Attention Deficit Disorder10.00% Coinsurance after deductible
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - Child50.00% Coinsurance after deductible
Chemotherapy10.00% Coinsurance after deductible
Chiropractic Care10.00% Coinsurance after deductible
Clinical Trials10.00% Coinsurance after deductible
Congenital Anomaly, including Cleft Lip/Palate10.00% Coinsurance after deductible
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care10.00% Coinsurance after deductible
Dental Anesthesia10.00% Coinsurance after deductible
Dental Check-Up for ChildrenNo charge
Diabetes Care Management10.00% Coinsurance after deductible
Diabetes Education10.00% Coinsurance after deductible
Dialysis10.00% Coinsurance after deductible
Durable Medical Equipment10.00% Coinsurance after deductible
Emergency Transportation/Ambulance10.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Habilitation Services10.00% Coinsurance after deductible
Hearing Aids10.00% Coinsurance after deductible
Home Health Care Services10.00% Coinsurance after deductible
Hospice Services10.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)10.00% Coinsurance after deductible
Infertility TreatmentNot covered
Infusion Therapy10.00% Coinsurance after deductible
Inherited Metabolic Disorder - PKU10.00% Coinsurance after deductible
Inpatient Physician and Surgical Services10.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services10.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - Child50.00% Coinsurance after deductible
Non-Emergency Care When Traveling Outside the U.S.30.00% Coinsurance after deductible
Nutritional Counseling10.00% Coinsurance after deductible
Orthodontia - AdultNot covered
Orthodontia - Child50.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)10.00% Coinsurance after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)10.00% Coinsurance after deductible
Outpatient Rehabilitation Services10.00% Coinsurance after deductible
Prenatal and Postnatal Care10.00% Coinsurance after deductible
Private-Duty Nursing10.00% Coinsurance after deductible
Prosthetic Devices10.00% Coinsurance after deductible
Radiation10.00% Coinsurance after deductible
Reconstructive Surgery10.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy10.00% Coinsurance after deductible
Rehabilitative Speech Therapy10.00% Coinsurance after deductible
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility10.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services10.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services10.00% Coinsurance after deductible
Transplant10.00% Coinsurance after deductible
Treatment for Temporomandibular Joint DisordersNot covered
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging10.00% Coinsurance after deductible

Plan rules

Service area

This plan covers 5 geographic areas.

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