Simply Blue℠ Routine Care PPO

These cost-saving routine care plans can help your employees plan for their health care with predictable costs.

Plan highlights
  • You'll get the features of a PPO and an HSA with the cost savings of a higher deductible plan. 
  • Prescription drug coverage is included. 
  • Preventive care is 100% covered.

NETWORK SIZE

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PREMIUM COST

$$

LEVEL OF CONSUMER ENGAGEMENT

LOW

INDIVIDUAL DEDUCTIBLE

$2,500 - $7,900

HOW PPO PLANS WORK

A preferred provider organization is a group of health care professionals who provide services at discounted rates to plan members.

PPO plans offer:

  • In- and out-of-network coverage
  • The ability to see a specialist without a referral from a primary care doctor
Want more details about Simply Blue Routine Care PPO?

Download plan certificate

Plan options

Silver $2,500

This is a standard-level plan with a $2,500 deductible.

Monthly premium

Medium

Deductible

$2,500

Out-of-pocket maximum

$8,150

PCP office visit copay

$30

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$2,500

$5,000

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$5,000

$10,000

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

30%

50%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

Not covered

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

Not covered

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$8,150

$16,300

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$16,300

$32,600

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

$30

50% after deductible

Preferred generic pharmacy copay

This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.

$10

$10 plus 25% of approved amount

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$2,500 $5,000

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$5,000 $10,000

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

30% 50%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A Not covered

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A Not covered

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$8,150 $16,300

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$16,300 $32,600

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

$30 50% after deductible

Preferred generic pharmacy copay

This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.

$10 $10 plus 25% of approved amount

Bronze $7,900

This is a base-level plan with a $7,900 deductible.

Monthly premium

Low

Deductible

$7,900

Out-of-pocket maximum

$7,900

PCP office visit copay

$30

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$7,900

$15,800

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$15,800

$31,600

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

0%

0%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

N/A

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A

N/A

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$7,900

$15,800

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$15,800

$31,600

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

$30

100% after deductible

Preferred generic pharmacy copay

This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.

$10

$10 plus 25% of approved amount

Individual annual deductible

An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. 

$7,900 $15,800

Family annual deductible

A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. 

$15,800 $31,600

Coinsurance percentage

Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.

0% 0%

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A N/A

Embedded coinsurance maximum

The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.

N/A N/A

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$7,900 $15,800

Out-of-pocket maximum

This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.

$15,800 $31,600

PCP office visit copay

This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.

$30 100% after deductible

Preferred generic pharmacy copay

This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.

$10 $10 plus 25% of approved amount
THE BLUE CROSS DIFFERENCE

See how Smarter, Better Healthcare℠ tackles your small business challenges

Network access and solutions

Choices for care

Helping your employees avoid costly ER visits and get the care they need quickly and conveniently.

Value-based care

Elevating the quality of care by rewarding physicians for better patient health outcomes.

Improved care for healthy employees

Coordinated Care

A care management support program for your employees and their family members who face complex issues.

Health & Well-Being

Encourage a culture of well-being with tools and resources to help your employees improve their whole health.

Personalized member engagement

Online member account

Your employees will get the tools, information and support they need all under one secure online account.

Blue Cross Rewards

Incentivizing employees to use cost-effective providers by using our “Find Care” tools.

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