Tuesday, January 14, 2014

Invidiual and Family Plans

From Blue Cross Blue Shield


Individual and Family Plans

Choosing the right individual health insurance plan to fit your needs is important to you and your family. Compare our insurance plans to find the coverage you need, and get a quick quote before you apply.


All of our plans follow the Affordable Care Act guidelines and provide the same set of essential health benefits, quality and amount of care. The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are.
If you need major medical coverage before Jan. 1, 2014, contact the sales call center or an authorized agent.
Platinum Plans
Platinum Plans have the highest monthly premium and often the lowest out-of-pocket costs. In most cases, platinum plans cover 90% of costs, while you cover 10%.
To help you compare all of the platinum plans, we are providing the Summary of Benefits and Coverage (SBC) documents below. These SBCs describe key features such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions.
All platinum plans offer the same set of essential health benefits, quality and amount of care. The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are.
Platinum plans have the highest premium and often the lowest out-of-pocket costs. In most cases, platinum plans cover 90% of costs, while you cover 10%.
Information in these SBCs represents an overview of coverage. It is not a complete list of what is covered or not included. Information may change. The full terms of coverage are located in the insurance policy.

Gold Plans

Gold Plans have a higher monthly premium and often lower out-of-pocket costs than silver plans. In most cases, gold plans cover 80% of costs, while you cover 20%.
To help you compare all of the gold plans, we are providing the Summary of Benefits and Coverage (SBC) documents below. These SBCs describe key features such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions.
All gold plans offer the same set of essential health benefits, quality and amount of care. The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are.
Gold Plans have a higher monthly premium and often lower out-of-pocket costs than silver plans. In most cases, gold plans cover 80% of costs, while you cover 20%.
Information in these SBCs represents an overview of coverage. It is not a complete list of what is covered or excluded. Information is subject to change. The full terms of coverage are located in the insurance policy.
Silver Plans
Silver Plans have slightly higher monthly premiums and often lower out-of-pocket costs than bronze plans. In most cases, silver plans cover 70% of costs, while you cover 30%.
To help you compare all of the silver plans, we are providing the Summary of Benefits and Coverage (SBC) documents below. These SBCs describe key features such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions.
All silver plans offer the same set of essential health benefits, quality and amount of care. The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are.
Silver plans have a higher monthly premium and often lower out-of-pocket costs than bronze plans. In most cases, silver plans cover 70% of costs, while you cover 30%. Silver plans are the only plans that offer cost sharing discounts. These discounts help lower the out-of-pocket costs like your deductible, copayment and coinsurance.
Information in these SBCs represents an overview of coverage. It is not a complete list of what is covered or excluded. Information is subject to change. The full terms of coverage are located in the insurance policy.
Bronze Plans
Bronze Plans have the lowest monthly premium and often the highest out-of-pocket costs. In most cases, bronze plans cover 60% of costs, while you cover 40%.
To help you compare all of the bronze plans, we are providing the Summary of Benefits and Coverage (SBC) documents below. These SBCs describe key features such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions.
All bronze plans offer the same set of essential health benefits, quality and amount of care. The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are.
Bronze plans have the lowest monthly premium and often the highest out-of-pocket costs. In most cases, bronze plans cover 60% of costs, while you cover 40%.
Information in these SBCs represents an overview of coverage. It is not a complete list of what is covered or excluded. Information is subject to change. The full terms of coverage are located in the insurance policy.
Catastrophic Plans
Catastrophic health care plans are available for people under 30 and to some low-income people. A catastrophic health insurance plan has a lower premium than other health plans, but has a high deductible. It is meant to serve as a "safety net" to cover large medical costs in case of a serious illness or injury.
To help you compare different plans, we are providing the Summary of Benefits and Coverage (SBC) documents below. These SBCs describe key features such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions.
Catastrophic health care plans are available for people under 30 and to some low-income people. A catastrophic health insurance plan has a lower premium than other health plans, but has a high deductible. It is meant to serve as a "safety net" to cover large medical costs in case of a serious illness or injury.
Costs vary by deductible, coinsurance, copayment, out-of-pocket expenses. Some plans qualify for a cost-sharing discount which can lower your monthly costs. Cost sharing discounts vary by plan, income level and Native American status. See details in the Summary of Benefits and Coverage.
Short-Term Plans
Short-term health insurance can give you temporary coverage for 1-11 months. It covers many of the most costly health care services and keeps you and your family protected.

Short-term Health Insurance Overview

SelecTEMP® PPO provides temporary health coverage for you, your spouse and your children. It offers various benefit periods and deductibles to give you the control to tailor coverage, premium rates and out-of-pocket expenses according to your own needs.

SelecTEMP PPO Coverage Overview

Key features include:
  • Inpatient and outpatient medical, surgical and hospital services
  • Diagnostic services
  • Emergency care
  • Office visits
  • Childhood immunizations up to the child’s eighth birthday
  • Prescription drug coverage
SelecTEMP PPO is your short-term health insurance solution if you are:
  • Experiencing a gap in employer coverage or can’t afford COBRA
  • Waiting for employer coverage to begin
  • A recent graduate and still seeking employment
  • Age 64 and about to retire, but not yet eligible for Medicare

Who is eligible for SelecTEMP PPO?

  • Texas residents at least 60 days of age and under 65 years of age
  • Non-expectant parents
  • Unmarried dependent children at least 60 days of age and under 25 years of age
  • U.S. citizens or non-U.S. citizens living in the United States for at least two years (a copy of your Alien Registration Receipt Card must be submitted with your application)
Dental Plans

If you enroll in a Blue Cross and Blue Shield health plan, you may be eligible to enroll in a dental plan. For more information, call us at 1-888-697-0683.

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.
© Copyright 2014 Health Care Service Corporation. All Rights Reserved.


Lewis Insurance
2525 S. Lamar Ste 11
Austin, TX
78704

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