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BlueCross BlueShield of Tennessee Health Insurance in TENNESSEE – Health Plan Options

BlueCross BlueShield of Tennessee — PremierBlue A01S

A comparison of the PremierBlue A01S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A02S

A comparison of the PremierBlue A02S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A04S

A comparison of the PremierBlue A04S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A12S

A comparison of the PremierBlue A12S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A14S

A comparison of the PremierBlue A14S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A18S

A comparison of the PremierBlue A18S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A22S

A comparison of the PremierBlue A22S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A24S

A comparison of the PremierBlue A24S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A25S

A comparison of the PremierBlue A25S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A28S

A comparison of the PremierBlue A28S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A31S

A comparison of the PremierBlue A31S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A32S

A comparison of the PremierBlue A32S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A34S

A comparison of the PremierBlue A34S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A42S

A comparison of the PremierBlue A42S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A44S

A comparison of the PremierBlue A44S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A48S

A comparison of the PremierBlue A48S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A52S

A comparison of the PremierBlue A52S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A54S

A comparison of the PremierBlue A54S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A55S

A comparison of the PremierBlue A55S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A58S

A comparison of the PremierBlue A58S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A01P

A comparison of the PremierBlue A01P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A02P

A comparison of the PremierBlue A02P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A04P

A comparison of the PremierBlue A04P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A12P

A comparison of the PremierBlue A12P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A14P

A comparison of the PremierBlue A14P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A18P

A comparison of the PremierBlue A18P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A22P

A comparison of the PremierBlue A22P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A24P

A comparison of the PremierBlue A24P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A25P

A comparison of the PremierBlue A25P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A28P

A comparison of the PremierBlue A28P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A31P

A comparison of the PremierBlue A31P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A32P

A comparison of the PremierBlue A32P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A34P

A comparison of the PremierBlue A34P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $25 copay Specialist- $40 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $25 Specialist- $40	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A42P

A comparison of the PremierBlue A42P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A44P

A comparison of the PremierBlue A44P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A48P

A comparison of the PremierBlue A48P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Primary Care Physician- $35 copay Specialist- $50 copay	Subject to deductible and coinsurance.
Copay	Primary Care Physician- $35 Specialist- $50	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A52P

A comparison of the PremierBlue A52P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A54P

A comparison of the PremierBlue A54P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A55P

A comparison of the PremierBlue A55P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

BlueCross BlueShield of Tennessee — PremierBlue A58P

A comparison of the PremierBlue A58P offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible and coinsurance.	Subject to deductible and coinsurance.
Copay	N/A	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

BlueCross BlueShield of Tennessee — SimplyBlue S1S

A comparison of the SimplyBlue S1S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$1,000 Individual/ $2,000 Family	$2,000 Individual/ $4,000 Family

BlueCross BlueShield of Tennessee — SimplyBlue S2S

A comparison of the SimplyBlue S2S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	N/A	N/A
Copay	N/A	N/A
Deductible	$1,500 Individual/ $3,000 Family	$3,000 Individual/ $6,000 Family

BlueCross BlueShield of Tennessee — SimplyBlue S3S

A comparison of the SimplyBlue S3S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$2,500 Individual/ $5,000 Family	$5,000 Individual/ $10,000 Family

BlueCross BlueShield of Tennessee — SimplyBlue S4S

A comparison of the SimplyBlue S4S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to deductible	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$3,500 Individual/ $7,000 Family	$7,000 Individual/ $14,000 Family

BlueCross BlueShield of Tennessee — SimplyBlue S5S

A comparison of the SimplyBlue S5S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	N/A	N/A
Copay	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).
Deductible	$1,000 Individual/ $2,000 Family	$2,000 Individual/ $4,000 Family

BlueCross BlueShield of Tennessee — SimplyBlue S6S

A comparison of the SimplyBlue S6S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	N/A	N/A
Copay	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).
Deductible	$1,500 Individual/ $3,000 Family	$3,000 Individual/ $6,000 Family

BlueCross BlueShield of Tennessee — SimplyBlue S7S

A comparison of the SimplyBlue S7S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).
Copay	$30	$30
Deductible	$2,500 Individual/ $5,000 Family	$5,000 Individual/ $10,000 Family

BlueCross BlueShield of Tennessee — SimplyBlue S8S

A comparison of the SimplyBlue S8S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).	$30 Copay- Medically necessary treatment for illness or injuries at your network physician's office (Limit two per calendar year) and Covered preventive services and screenings (No limits on the number of visits).
Copay	$30	$30
Deductible	$3,500 Individual/ $7,000 Family	$7,000 Individual/ $14,000 Family

BlueCross BlueShield of Tennessee — BluePartner D1S

A comparison of the BluePartner D1S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$1,200 Individual/ $2,400 Family	$2,400 Individual/ $4,800 Family

BlueCross BlueShield of Tennessee — BluePartner D2S

A comparison of the BluePartner D2S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$1,800 Individual/ $2,400 Family	$3,600 Individual/ $7,200 Family

BlueCross BlueShield of Tennessee — BluePartner D3S

A comparison of the BluePartner D3S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$2,850 Individual/ $5,650 Family	$5,700 Individual/ $11,400 Family

BlueCross BlueShield of Tennessee — BluePartner D4S

A comparison of the BluePartner D4S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$5,500 Individual/ $11,000 Family	$11,000 Individual/ $22,000 Family

BlueCross BlueShield of Tennessee — BluePartner D1S

A comparison of the BluePartner D1S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	60%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$1,200 Individual/ $2,400 Family	$2,400 Individual/ $4,800 Family

BlueCross BlueShield of Tennessee — BluePartner D2S

A comparison of the BluePartner D2S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$1,800 Individual/ $2,400 Family	$3,600 Individual/ $7,200 Family

BlueCross BlueShield of Tennessee — BluePartner D3S

A comparison of the BluePartner D3S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$2,850 Individual/ $5,650 Family	$5,700 Individual/ $11,400 Family

BlueCross BlueShield of Tennessee — BluePartner D4S

A comparison of the BluePartner D4S offered by BlueCross BlueShield of Tennessee is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	80%
Office Visit	Subject to Deductible and Coinsurance	Subject to Deductible and Coinsurance
Copay	See Preventative Section	See Preventative Section
Deductible	$5,500 Individual/ $11,000 Family	$11,000 Individual/ $22,000 Family