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Blue Cross Blue Shield of New Mexico BlueDirect Basic – New Mexico Health Insurance Plan

A detailed comparison of the Blue Cross Blue Shield of New Mexico BlueDirect Basic health insurance plan as offered in New Mexico is listed below for both Network and Non-Network coverage. This is a review of the coverage for this specific Blue Cross Blue Shield of New Mexico plan. However, GoHealthInsurance offers a large variety of health insurance options to fit your needs. If you wish, get a new Blue Cross Blue Shield of New Mexico health insurance quote for New Mexico now or view all of our Blue Cross Blue Shield of New Mexico health insurance quotes.

  Network Non-Network
Copay $40 copay/visit 50%
OfficeVisit Office Visits (nonroutine; All other services received during the office visit are subject to deductible and coinsurance as listed below): $40 copay/visit (deductible waived)
  • Office Surgery (including casts, splints, and dressings): Plan pays 70%
Office Visits (nonroutine; All other services received during the office visit are subject to deductible and coinsurance as listed below): Plan pays 50%
  • Office Surgery (including casts, splints, and dressings): Plan pays 50% after deductible
  • La
Deductible true Individual: $2,000, Family: $4,000 Individual: $4,000, Family: $8,000
Coinsurance 70% 50%
Coinsurance Limit N/A N/A
Out-of-Pocket Maximum
Lifetime Maximum None None
Prescription Drugs Prescription Drugs, Insulin, Diabetic Supplies, Nutritional Products, Special Medical Foods): 4-Tier Rx Plan - $15/$45/$75/85% (see your Drug Plan Rider for additional details) Prescription Drugs, Insulin, Diabetic Supplies, Nutritional Products, Special Medical Foods): 4-Tier Rx Plan - $15/$45/$75/85% (see your Drug Plan Rider for additional details)
Emergency Room Emergency Room Treatment (includes all ER services): $250 copay/visit; Ambulance Services (Ground and Emergency Air Transport): Plan pays 70% Emergency Room Treatment (includes all ER services): $250 copay/visit; Ambulance Services (Ground and Emergency Air Transport): Plan pays 70%
Adult Preventative Care Preventive Services: Routine Adult Physicals and Gynecological Exams, Related Testing (includes routine Pap tests, mammograms, routine colonoscopies, cholesterol tests, urinalysis, etc.)- No Charge Preventive Services: Routine Adult Physicals and Gynecological Exams, Related Testing (includes routine Pap tests, mammograms, routine colonoscopies, cholesterol tests, urinalysis, etc.)- No Charge
Child Preventative Care Well-Child Care, Immunizations, Routine Testing, Routine Vision or Hearing Screenings: No charge Well-Child Care, Immunizations, Routine Testing, Routine Vision or Hearing Screenings: No charge
Lab / X-Ray Plan pays 70% Plan pays 50%
Maternity Not covered Not covered
Physical Therapy Short-Term Rehabilitation (Occupational, Physical, and Speech Therapy):
  • Inpatient Rehab & Skilled Nursing Facility (max. 30 days/year): Plan pays 70%
  • Outpatient and Office Therapies (max. 20 visits/year combined): Plan pays 70%
Short-Term Rehabilitation (Occupational, Physical, and Speech Therapy):
  • Inpatient Rehab & Skilled Nursing Facility (max. 30 days/year): Plan pays 50%
  • Outpatient and Office Therapies (max. 20 visits/year combined): Plan pays 50%
Home Health Care Home Health Care/Home I.V. Services (max. 100 visits/year combined): 70%; Hospice: Plan pays 70% Home Health Care/Home I.V. Services (max. 100 visits/year combined): 50%; Hospice: Plan pays 50%
Mental Health Not covered Not covered
Hospital Care Inpatient Hospital/Facility Services: Room and Board and Physician Care such as Physician Visits, Surgeon, and Anesthesiologist: Plan pays 70% ; Routine Nursery Care for Covered Newborn Infants: Plan pays 70%; Lab, X-Ray, and Other Diagnostic Tests: Plan Inpatient Hospital/Facility Services: Room and Board and Physician Care such as Physician Visits, Surgeon, and Anesthesiologist: Plan pays 50%; Routine Nursery Care for Covered Newborn Infants: Plan pays 50%; Lab, X-Ray, and Other Diagnostic Tests: Plan p
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