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

A detailed comparison of the Blue Cross Blue Shield of New Mexico BlueDirect Premier 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 $20 copay/visit 70%
OfficeVisit Office Visits (nonroutine; All other services received during the office visit are subject to deductible and coinsurance as listed below): $20 copay/visit (deductible waived)
  • Office Surgery (including casts, splints, and dressings): 85% after dedu
Office Visits (nonroutine; All other services received during the office visit are subject to deductible and coinsurance as listed below): Plan pays 70%
  • Office Surgery (including casts, splints, and dressings): Plan pays 70% after deductible
  • La
Deductible true Individual: $500, Family: $1,000 Individual: $1,000, Family: $2,000
Coinsurance 85% 70%
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: $7/$35/$65/85% (see your Drug Plan Rider for additional details) Prescription Drugs, Insulin, Diabetic Supplies, Nutritional Products, Special Medical Foods: $7/$35/$65/85% (see your Drug Plan Rider for additional details)
Emergency Room Emergency Room Treatment (includes all ER services): $150 copay/visit; Ambulance Services (Ground and Emergency Air Transport): Plan pays 85% Emergency Room Treatment (includes all ER services): $150 copay/visit; Ambulance Services (Ground and Emergency Air Transport): Plan pays 85%
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 85% Plan pays 70%
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 85%
  • Outpatient and Office Therapies (max. 20 visits/year combined): Plan pays 85%
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%
Home Health Care Home Health Care/Home I.V. Services (max. 100 visits/year combined): 85%; Hospice: Plan pays 85% Home Health Care/Home I.V. Services (max. 100 visits/year combined): 70%; Hospice: Plan pays 70%
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 85% ; Routine Nursery Care for Covered Newborn Infants: Plan pays 85%; 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 70%; Routine Nursery Care for Covered Newborn Infants: Plan pays 70%; Lab, X-Ray, and Other Diagnostic Tests: Plan p
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