Blue Care Network Routine Care HMO breakdown
BCN Routine Care HMO
Plan options
Silver $3,000 Bronze $8,150
Annual deductible
(individual / family)
$3,000 / $6,000 $8,150 / $16,300
Coinsurance Percentage 30% 0%
Embedded
Coinsurance Maximum

(individual / family)
N/A N/A
Out-of-pocket maximum
(individual / family)
$8,150 / $16,300
$8,150 / $16,300
PCP office visit copay
$30 $30
Preferred generic pharmacy copay
$6 $6

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