March 19, 2010

Your source for health insurance quotes and plans.

Quick Links

See how easy it is to get free quotes…

Safe, Secure & Absolutely Free

This website's security is certifed by:

TrustE Verisign

Blue Cross Blue Shield of Louisiana – BLUE MAX PPO – LOUISIANA

A comparison of the BLUE MAX PPO offered by Blue Cross Blue Shield of Louisiana is detailed out below for both Network and Non-Network coverage.

  Network Non-Network
Get Instant Quotes
Network See Provider See Provider
Application BLUE MAX PPO Application BLUE MAX PPO Application
Brochure BLUE MAX PPO Brochure BLUE MAX PPO Brochure
Copay $20 60% after deductible
Office Visit $20 Subject to deductible and coinsurance.
Deductible $250 Individual, $750 Family $250 Individual, $750 Family
Coinsurance 80% 60%
Coinsurance Limit Out-of-Pocket Maximum- $2,000 per calendar year Out-of-Pocket Maximum- $2,000 per calendar year
Out-of-Pocket Maximum $2,000 per calendar year $2,000 per calendar year
Lifetime Maximum $5 million for each covered member $5 million for each covered member
Prescription Drugs
  • Generic drugs (and certain brand-name drugs)- $4
  • Brand-name drugs (and certain generic drugs)- $25
  • Generic or brand-name drugs with a therapeutic alternative- $45
  • Multi-Source Brand drugs- $60
  • Injectables- $50.
  • For retail pharmacies, the copayment covers up to a 30-day supply.
  • Mail-order services are also available. When ordering drugs by mail, you pay three copayments and receive up to a 90-day supply. A separate copayment is required for each dispensing you receive
    		•
  • Generic drugs (and certain brand-name drugs)- $4
  • Brand-name drugs (and certain generic drugs)- $25
  • Generic or brand-name drugs with a therapeutic alternative- $45
  • Multi-Source Brand drugs- $60
  • Injectables- $50.
  • For retail pharmacies, the copayment covers up to a 30-day supply.
  • Mail-order services are also available. When ordering drugs by mail, you pay three copayments and receive up to a 90-day supply. A separate copayment is required for each dispensing you receive
    		•
    Emergency Room Subject to deductible and coinsurance. Subject to deductible and coinsurance.
    Adult Preventative Care Covered 100%- One routine Pap smear per calendar year, One routine physical per benefit period, One mammography exam per benefit period, One routine colon (hemoccult) test per calendar year, One routine gynecological exam per calendar year, and One prostate (PSA) screening test and one digital rectal exam per calendar year for members age 50 and older, or more frequently if recommended by physician. Subject to deductible and coinsurance.
    Child Preventative Care Covered 100%- Routine pediatric exams and all immunizations. Subject to deductible and coinsurance.
    Lab / X-Ray Subject to deductible and coinsurance. Subject to deductible and coinsurance.
    Maternity BLUE MAX PPO BLUE MAX PPO
    Physical Therapy
  • Subject to deductible and coinsurance.
  • Limited to $4,500 combined maximum each Benefit Period.
    		•
  • Subject to deductible and coinsurance.
  • Limited to $4,500 combined maximum each Benefit Period.
    		•
    Skilled Nursing BLUE MAX PPO BLUE MAX PPO
    Home Health Care BLUE MAX PPO BLUE MAX PPO
    Mental Health Not covered Not covered
    Hospital Care Subject to deductible and coinsurance. Subject to deductible and coinsurance.
    Optional Benefits BLUE MAX PPO BLUE MAX PPO