Blue Cross® Premier PPO Bronze Saver

Plan Type: PPO
Plan Tier: Bronze
Individual Deductible $8,500.00
Family Deductible $17,000.00
Individual Out of Pocket Max $8,500.00
Family Out of Pocket Max $17,000.00
Primary Care Visit: No Charge after Deductible
Specialist Visit: No Charge after Deductible
Emergency Room: No Charge after Deductible
Hospital - Physician: No Charge after Deductible
Hospital - Facility: No Charge after Deductible
Link to Full SBC: https://www.bcbsm.com/content/dam/public/marketplace/2021-individual/sbc/premier-bronze-saver-sbc.pdf
Plan Brochure: https://www.bcbsm.com/index/plans/michigan-health-insurance/2021/bronze/premier-ppo-saver.html

Other Coverage:

Child Dental: No
Adult Dental No

Prescription Drug Pricing:

Generic Drugs: No Charge after Deductible
Non-Preferred Brand Drugs: No Charge after Deductible
Preferred Brand Drugs: No Charge after Deductible
Specialty Drugs: No Charge after Deductible
Summary of Benefits https://www.bcbsm.com/2021selectdruglist

About The Carrier

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Michigan: Blue Cross Blue Shield Healthcare Plan of Michigan, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc.

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