Blue Saver Bronze

Blue Cross and Blue Shield of Alabama

Expanded BronzeHSA eligible

Ind. deductible: $8,500
Family deductible: $8,500
Ind. OOP max: $10,600
Family OOP max: $10,600

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	$371	—
30	$422	—
40	$475	—
50	$663	—
60	$1,008	—

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	$45.00

Specialist

Benefit	In-network
Specialist Visit	$90.00

Hospital

Benefit	In-network
Emergency Room Services	0.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	0.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	0.00% Coinsurance after deductible
Urgent Care Centers or Facilities	$45.00

Pharmacy

Benefit	In-network
Generic Drugs	$5.00
Non-Preferred Brand Drugs	$0.00
Preferred Brand Drugs	10.00% Coinsurance after deductible
Specialty Drugs	20.00% Coinsurance after deductible

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	$0.00
Mental/Behavioral Health Outpatient Services	$90.00

Other

Benefit	In-network
Abortion for Which Public Funding is Prohibited	Not covered
Accidental Dental	0.00% Coinsurance after deductible
Acupuncture	Not covered
Allergy Testing	0.00% Coinsurance after deductible
Bariatric Surgery	Not covered
Basic Dental Care - Adult	Not covered
Basic Dental Care - Child	$0.00
Chemotherapy	0.00% Coinsurance after deductible
Chiropractic Care	0.00% Coinsurance after deductible
Cosmetic Surgery	Not covered
Delivery and All Inpatient Services for Maternity Care	$0.00
Dental Check-Up for Children	$0.00
Diabetes Education	0.00% Coinsurance after deductible
Dialysis	0.00% Coinsurance after deductible
Durable Medical Equipment	$0.00
Emergency Transportation/Ambulance	0.00% Coinsurance after deductible
Eye Glasses for Children	0.00% Coinsurance after deductible
Habilitation Services	0.00% Coinsurance after deductible
Hearing Aids	Not covered
Home Health Care Services	0.00% Coinsurance after deductible
Hospice Services	0.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	0.00% Coinsurance after deductible
Infertility Treatment	$90.00
Infusion Therapy	0.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	$0.00
Laboratory Outpatient and Professional Services	0.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home Care	Not covered
Major Dental Care - Adult	Not covered
Major Dental Care - Child	$0.00
Nutritional Counseling	Not covered
Orthodontia - Adult	Not covered
Orthodontia - Child	0.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)	$45.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	0.00% Coinsurance after deductible
Outpatient Rehabilitation Services	0.00% Coinsurance after deductible
Prenatal and Postnatal Care	0.00% Coinsurance after deductible
Private-Duty Nursing	Not covered
Prosthetic Devices	0.00% Coinsurance after deductible
Radiation	0.00% Coinsurance after deductible
Reconstructive Surgery	0.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	0.00% Coinsurance after deductible
Rehabilitative Speech Therapy	$0.00
Routine Dental Services (Adult)	Not covered
Routine Eye Exam (Adult)	Not covered
Routine Eye Exam for Children	$0.00
Routine Foot Care	Not covered
Skilled Nursing Facility	Not covered
Substance Abuse Disorder Inpatient Services	0.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	$0.00
Transplant	0.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	$0.00
Weight Loss Programs	Not covered
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	0.00% Coinsurance after deductible

Plan rules

Service area

This plan covers 1 geographic area.