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Blue Advantage PremierSM |
Blue Advantage HSASM Qualified |
Blue Advantage StandardSM |
Alliance Select ComprehensiveSM |
Alliance Select EnhancedSM |
Alliance Select ValueSM |
Blue Priority HSASM |
Blue BasicsSM |
Short-Term BlueSM |
| Maternity Coverage |
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| Complications only. Optional maternity benefit available for additional premium |
Complications only |
Complications only |
Covered |
Complications only |
Complications only |
Complications only. Optional maternity benefit available for additional premium |
Complications only |
Complications only |
Prescription Drugs
See Outlines of Coverage below for complete drug benefit information. |
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| Choose between a limited-coverage drug plan (Blue Rx Value) or a more complete drug plan (Blue Rx Complete) |
Includes Blue Rx Complete |
Choose between a limited-coverage drug plan (Blue Rx Value) or a more complete drug plan (Blue Rx Complete) |
Covered |
Covered |
Covered |
Covered |
Covered - generics only (with exceptions) |
Covered |
| Mental Health & Chemical Dependency Treatment |
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| 14 inpatient days/20 outpatient visits per benefit period |
Limited coverage |
Not covered |
Not covered |
Not covered |
Deductible followed by 50% coinsurance; other limitations apply |
Not covered |
| Preventive Care |
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| Covered. Services must be received from your designated PCP or OB/GYN |
Covered at no charge for Alliance Select providers |
Not covered |
| Contraceptive Coverage |
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Available for an additional premium. |
Not available |
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Included in all plans
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| Dental Coverage (Optional) |
Available for an additional premium |
Availailable for an additional premium. |
Not available |
| Outlines of Coverage |
Blue Advantage OOC (412KB) |
Alliance Select OOC (470KB)
Blue Basics OOC (446KB)
Blue Priority HSA OOC (457KB) |
Short-Term Blue OOC (782KB) |