Blue Plus Minnesota Value Silver CSR Plan 401e

HMO Minnesota dba Blue Plus · 2027 plan year

Silver
Ind. deductible
$0
Family deductible
$0
Ind. OOP max
$1,700
Family OOP max
$3,400

More HMO Minnesota dba Blue Plus plans in MN

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness35.00%

Specialist

BenefitIn-network
Specialist Visit35.00%

Hospital

BenefitIn-network
Emergency Room Services35.00%
Inpatient Hospital Services (e.g., Hospital Stay)35.00%
Outpatient Surgery Physician/Surgical Services35.00%
Urgent Care Centers or Facilities35.00%

Pharmacy

BenefitIn-network
Generic Drugs35.00%
Non-Preferred Brand Drugs50.00%
Preferred Brand Drugs35.00%
Specialty Drugs50.00%

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services35.00%
Mental/Behavioral Health Outpatient Services35.00%

Other

BenefitIn-network
Dialysis35.00%
Diabetes Education35.00%
Abortion for Which Public Funding is Prohibited35.00%
Accidental Dental35.00%
Allergy Testing35.00%
Chemotherapy35.00%
Chiropractic Care35.00%
Delivery and All Inpatient Services for Maternity Care35.00%
Durable Medical Equipment35.00%
Emergency Transportation/Ambulance35.00%
Eye Glasses for Children35.00%
Habilitation Services35.00%
Hearing Aids35.00%
Home Health Care Services35.00%
Hospice Services35.00%
Imaging (CT/PET Scans, MRIs)35.00%
Infusion Therapy35.00%
Inpatient Physician and Surgical Services35.00%
Laboratory Outpatient and Professional Services35.00%
Nutritional Counseling35.00%
Other Practitioner Office Visit (Nurse, Physician Assistant)35.00%
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)35.00%
Outpatient Rehabilitation Services35.00%
Prenatal and Postnatal CareNo charge
Prosthetic Devices35.00%
Radiation35.00%
Reconstructive Surgery35.00%
Rehabilitative Occupational and Rehabilitative Physical Therapy35.00%
Rehabilitative Speech Therapy35.00%
Routine Eye Exam for ChildrenNo charge
Skilled Nursing Facility35.00%
Substance Abuse Disorder Inpatient Services35.00%
Substance Abuse Disorder Outpatient Services35.00%
Transplant35.00%
Treatment for Temporomandibular Joint Disorders35.00%
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging35.00%

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