Blue Cross Blue Shield of New Mexico BlueDirect Enhanced – New Mexico Health Insurance Plan
A detailed comparison of the Blue Cross Blue Shield of New Mexico BlueDirect Enhanced 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 | $25 copay/visit | 60% |
| OfficeVisit | Office Visits (nonroutine; All other services received during the office visit are subject to deductible and coinsurance as listed below): $25 copay/visit (deductible waived)
|
Office Visits (nonroutine; All other services received during the office visit are subject to deductible and coinsurance as listed below): Plan pays 60%
|
| Deductible true | Individual: $3,500, Family: $7,000 | Individual: $7,000, Family: $14,000 |
| Coinsurance | 80% | 60% |
| 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 - $10/40/70/85% (see your Drug Plan Rider for additional details) | Prescription Drugs, Insulin, Diabetic Supplies, Nutritional Products, Special Medical Foods: 4-Tier Rx Plan - $10/40/70/85% (see your Drug Plan Rider for additional details) |
| Emergency Room | Emergency Room Treatment (includes all ER services): $200 copay/visit; Ambulance Services (Ground and Emergency Air Transport): Plan pays 80% | Emergency Room Treatment (includes all ER services): $200 copay/visit; Ambulance Services (Ground and Emergency Air Transport): Plan pays 80% |
| 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 80% | Plan pays 60% |
| Maternity | Not covered | Not covered |
| Physical Therapy | Short-Term Rehabilitation (Occupational, Physical, and Speech Therapy):
|
Short-Term Rehabilitation (Occupational, Physical, and Speech Therapy):
|
| Home Health Care | Home Health Care/Home I.V. Services (max. 100 visits/year combined): 80%; Hospice: Plan pays 80% | Home Health Care/Home I.V. Services (max. 100 visits/year combined): 60%; Hospice: Plan pays 60% |
| 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 80%; Routine Nursery Care for Covered Newborn Infants: Plan pays 80%; Lab, X-Ray, and Other Diagnostic Tests: Plan p | Inpatient Hospital/Facility Services: Room and Board and Physician Care such as Physician Visits, Surgeon, and Anesthesiologist: Plan pays 60%; Routine Nursery Care for Covered Newborn Infants: Plan pays 60%; Lab, X-Ray, and Other Diagnostic Tests: Plan p |
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