Available 2015 Blue ACA Individual & Family Metal Plans
All of our 2015 Blue ACA Metal plans come with the same set of Essential Health Benefit categories. This means, no matter what plan you choose, you’re covered—doctor and ER visits, hospital stays, prescription drugs and much more. And you’ll pay nothing for most preventive services, such as wellness visits, immunizations, screenings for cancer and other diseases. Each metal level (Platinum, Gold, Silver and Bronze) offers a different way to manage your health care costs. And a Catastrophic plan gives “just in case” coverage to protect you from major unexpected medial costs.
Platinum plans offer the richest coverage with the lowest in-network deductibles and prescription drug coverage with low or no copays. This makes a Platinum plan a good choice if you typically need health care services, have a chronic condition and/or take maintenance medications.
Gold plans are a good choice if you see your doctor often and take regular prescription drugs. Our Gold plans come with prescription drug coverage with no or low copays and your preventive care is covered at no cost.
When you choose a Silver plan, you pay a little less each month, and have average costs when you need care. This makes a Silver plan a good choice if you use an average amount of health care services and preventive care. And with the Silver plan, you may qualify for reduced out-of-pocket costs for care. This makes a Silver plan the best value for your health care dollars.
When you choose a Bronze plan, you can keep your monthly premium low by paying higher costs when you need care. Bronze plans include prescription drug benefits and no out-of-pocket costs for preventive care. This makes a Bronze plan a good choice if you don’t need a lot of medical care and don’t often take prescription drugs.
A Catastrophic plan covers Essential Health Benefits after you pay out of your own pocket up to $6,350. Three office visits are paid in full and your preventive care is also covered at no cost to you. When you choose a Catastrophic plan, you pay a very low monthly premium for very limited coverage. This makes a Catastrophic plan a good choice if you don’t use a lot of medical services and want “just in case” coverage for major unexpected medical costs.
You can enroll in the Catastrophic plan only if you are under 30. If you are 30 or older, you can enroll in the Catastrophic plan ONLY if you have certification from the Marketplace that you are exempt from the individual mandate due to an extreme financial hardship.
Under the Affordable Care Act (ACA) the Office of Personnel Management (OPM) is required to offer OPM sponsored plans on Marketplaces. Blue Cross and Blue Shield ® Plans participate by offering Multi-State Plans on Marketplaced in 30 states and the District of Columbia. By 2017, Multi-State Plans will be offered across all states and in D.C. The Multi-State Plans are like the other ACA Metal plans offered on Marketplaces and generally, all of the same requirements apply.
Need More Information?
If you have questions about your coverage, call Customer Service at the number on the back of your Member ID card. We’re here weekdays, between 8 a.m. and 8 p.m. ET. Or, you can email us anytime.
CHIP offers comprehensive health insurance coverage for children and teens. CHIP covers check-ups and well visits, prescriptions, immunizations and much more. Every uninsured child and teen (up to age 19), who is not eligible for Medical Assistance and who meets the requirements, is eligible for CHIP.
Need More Information?
Find out if your child or teen is eligible. No family makes too much money for CHIP and almost everyone qualifies. How much you make determines how much you pay each month for your child’s CHIP health insurance coverage.
To learn more, and to apply for CHIP coverage, visit the CHIP page on BlueCrossNEPAStore.com. Or call CHIP Customer Service at 1.800.543.7199, weekdays between 8 a.m. and 5 p.m.
Available Medicare Eligible Plans
Medicare is a comprehensive health insurance plan for people 65 and older and the disabled. Your initial enrollment period for Medicare is 7 months, and begins 3 months before the month you turn 65 and ends 3 months after the month you turn 65. While Medicare covers most of your health care needs, it does not cover everything. Complementary or supplemental coverage is available with plans like BlueCare® Security and FreedomBlueSM PPO. These plans help you pay some the health care cost that Medicare does not pay (like coinsurance, copays and deductibles).
Need More Information?
Call the customer service number on the back of your Member ID card. We are available weekdays, between 8 a.m. and 5 p.m. ET. Or, you can email us through Self-Service.