HMO plan

Blue Cross® Metro Detroit HMO Bronze Saver HSA

2021 plan year

You can buy this plan if you live in Macomb, Oakland or Wayne county.

About this plan

The Blue Cross HMO Bronze Saver HSA plan has a low monthly premium, but you'll pay a higher deductible. It's available in the Metro Detroit, Select and Preferred networks. Plan benefits are available in all three networks, but costs may vary.

Key Benefits

This plan includes benefits that help you and your family at no extra cost.

- Free annual visit
- Free wellness visits for kids
- Free vaccinations
- Free Health Savings Accounts (HSAs)
- Free diabetes test strips, lancets and monitors through diabetes management program
- Free online visits after deductible

- Free app - access to cost and transparency tools
- Discounts at gyms ($29 per month fee for access to over 10,000 gyms)
- Blue 365 discounts on vitamins, food, retailers, etc.
- Access to virtual visits and retail health clinics

Availability

You can buy this plan if you live in Macomb, Oakland or Wayne County. Look for doctors and hospitals that take this plan.

Plan Type

Metro Detroit HMO. You'll choose a primary care physician from the Metro Detroit HMO network who will refer you to other doctors in this plan's network. What’s the difference between HMO and PPO plans?

Find a doctorView map.

Health Savings Account

You can pair this plan with a health savings account, or HSA, which you can use to pay for medical expenses. Learn more about HSAs

Related Documents

For this plan's most-used benefits, see the Summary of Benefits (PDF)

For even more details about this plan, see the Certificate of Coverage (PDF)Certificates are legal documents that describe the benefits of a health insurance plan. Your plan might have different benefits and limitations than those listed in this document.

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Check out your coverage options to find a plan that’s right for you.

Overview

Monthly Premiums

To give you an accurate price, we'll need some information. Find a plan to get a quote.

Deductible

If you have a family plan, and one member meets the individual deductible, Blue Cross will start paying covered benefits for that member only. The remainder of the family deductible has to be met by the remaining family members before Blue Cross will start paying covered benefits for the rest of the members on the plan.
Any coupon, rebate or other credits received directly or indirectly from the drug manufacturer may not be applied to a consumer's deductible, cost-sharing or out-of-pocket maximum.

In network

Individual: $6,950
Family: $13,900

Out of network

Not Covered

Coinsurance

In network

You pay 0%.

Out of network

Not Covered

Out-of-pocket maximum

If you have a family plan, and one member meets the individual out-of-pocket maximum, Blue Cross will start paying 100% of the approved amount for covered benefits for that member only. The remainder of the family out-of-pocket maximum has to be met by the remaining family members before Blue Cross will start paying 100% of the approved amount for covered benefits for the rest of the members on the plan. Any coupon, rebate or other credits received directly or indirectly from the drug manufacturer may not be applied to a consumer's deductible, cost-sharing or out-of-pocket maximum.

In network

Individual: $6,950
Family: $13,900

Out of network

Not Covered

Office Visits

Primary Care

You pay $0 after deductible.

Specialist

You pay $0 after deductible.

Urgent care center

You pay $0 after deductible.

Emergency Room

You pay $0 after deductible.

Prescriptions

You pay $0 after you meet your deductible. See the prescriptions tab for more details.

Dental

This plan doesn't include dental coverage. To view our Dental plans please click.

Vision

This plan only includes vision coverage for children. To view our Vision plans please click.

Notes

Depending on the health care services you need, your provider might have to get approval before providing that service. Use our website to find more information and a list of services that need approval.

Estimated pricing information for various procedures by in-network providers can be obtained by calling the Customer Service number listed on the back of your BCN ID card and providing the procedure code. Your provider can also provide this information upon request.