By Ryan Kennelly
October 10, 2017
Topics:
October 10, 2017
There are 3 HSA eligible plans in Texas in 2021, available state-wide through Blue Cross Blue Shield of Texas and in the Austin & San Antonio area by Oscar Health Plans.
Health Savings Accounts can reduce your out of pocket costs as well as your tax burden. Learn more at our HSA Guide.
Bronze HMO| Plan ID: 33602TX0770108Bronze EPO| Plan ID: 20069TX0340001Silver EPO| Plan ID: 20069TX0350001
| BLUE CROSS AND BLUE SHIELD OF TEXAS · BLUE ADVANTAGE PLUS BRONZE℠ 201 | OSCAR · SAVER BRONZE | OSCAR · SAVER SILVER |
|---|---|---|
| Estimated monthly premium | Estimated monthly premium | Estimated monthly premium |
| $379.81 | $230.91 | $317.11 |
| Deductible | Deductible | Deductible |
| $2,850 Individual | $6,500 Individual | $5,000 Individual |
| Out-of-pocket maximum | Out-of-pocket maximum | Out-of-pocket maximum |
| $6,550 Individual Total | $6,500 Individual Total | $5,000 Individual Total |
| Copayments / Coinsurance | Copayments / Coinsurance | Copayments / Coinsurance |
| Emergency room care: $950 Copay with deductible/40% Coinsurance after deductible | Emergency room care: No Charge After Deductible | Emergency room care: No Charge After Deductible |
| Generic drugs: 20% Coinsurance after deductible | Generic drugs: No Charge After Deductible | Generic drugs: No Charge After Deductible |
| Primary doctor: 40% Coinsurance after deductible | Primary doctor: No Charge After Deductible | Primary doctor: No Charge After Deductible |
| Specialist doctor: 40% Coinsurance after deductible | Specialist doctor: No Charge After Deductible | Specialist doctor: No Charge After Deductible |
| DOCUMENTS | DOCUMENTS | DOCUMENTS |
| Summary of Benefits | Summary of Benefits | Summary of Benefits |
| Plan brochure | Plan brochure | Plan brochure |
| Costs for medical care | Costs for medical care | Costs for medical care |
| Deductible | Deductible | Deductible |
| $2,850 Individual Total | $6,500 Individual Total | $5,000 Individual Total |
| Out-of-pocket maximum | Out-of-pocket maximum | Out-of-pocket maximum |
| $6,550 Individual Total | $6,500 Individual Total | $5,000 Individual Total |
| Primary care doctor visit | Primary care doctor visit | Primary care doctor visit |
| In Network Tier 1: 40% Coinsurance after deductible | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 2: Not Applicable | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| Out of Network: 50% Coinsurance after deductible | ||
| Specialist visit | Specialist visit | Specialist visit |
| In Network Tier 1: 40% Coinsurance after deductible | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 2: Not Applicable | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| Out of Network: 50% Coinsurance after deductible | ||
| X-rays and diagnostic imaging | X-rays and diagnostic imaging | X-rays and diagnostic imaging |
| Limits and exclusions apply: X-rays and diagnostic imaging | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: 30% Coinsurance after deductible | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: Not Applicable | ||
| Out of Network: 50% Coinsurance after deductible | ||
| Laboratory outpatient and professional services | Laboratory outpatient and professional services | Laboratory outpatient and professional services |
| Limits and exclusions apply: Laboratory outpatient and professional services | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: 30% Coinsurance after deductible | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: Not Applicable | ||
| Out of Network: 50% Coinsurance after deductible | ||
| Outpatient facility | Outpatient facility | Outpatient facility |
| Limits and exclusions apply: Outpatient facility | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: $600 Copay with deductible/30% Coinsurance after deductible | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: Not Applicable | ||
| Out of Network: $1500 Copay with deductible/50% Coinsurance after deductible | ||
| Outpatient professional services | Outpatient professional services | Outpatient professional services |
| In Network Tier 1: $200 Copay with deductible/40% Coinsurance after deductible | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 2: Not Applicable | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| Out of Network: 50% Coinsurance after deductible | ||
| Hearing aids | Hearing aids | Hearing aids |
| Limits and exclusions apply: Hearing aids | Limits and exclusions apply: Hearing aids | Limits and exclusions apply: Hearing aids |
| In Network Tier 1: 40% Coinsurance after deductible | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 2: Not Applicable | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| Out of Network: 50% Coinsurance after deductible | ||
| Routine eye exam for adults | Routine eye exam for adults | Routine eye exam for adults |
| In Network: Benefit Not Covered | In Network: Benefit Not Covered | In Network: Benefit Not Covered |
| Routine eye exam for children | Routine eye exam for children | Routine eye exam for children |
| Limits and exclusions apply: Routine eye exam for children | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: No Charge | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: Not Applicable | ||
| Out of Network: Benefit Not Covered | ||
| Eyeglasses for children | Eyeglasses for children | Eyeglasses for children |
| Limits and exclusions apply: Eyeglasses for children | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: No Charge After Deductible | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: Not Applicable | Eligible for Health Savings Account (HSA)YesPrescription drug coverage | Eligible for Health Savings Account (HSA)YesPrescription drug coverage |
| Out of Network: Benefit Not Covered | ||
| Eligible for Health Savings Account (HSA)YesPrescription drug coverage | ||
| Generic drugs | Generic drugs | Generic drugs |
| Limits and exclusions apply: Generic drugs | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: 20% Coinsurance after deductible | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: 25% Coinsurance after deductible | ||
| Out of Network: 50% Coinsurance after deductible | ||
| Preferred brand drugs | Preferred brand drugs | Preferred brand drugs |
| Limits and exclusions apply: Preferred brand drugs | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: 30% Coinsurance after deductible | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: 35% Coinsurance after deductible | ||
| Out of Network: 50% Coinsurance after deductible | ||
| Non-preferred brand drugs | Non-preferred brand drugs | Non-preferred brand drugs |
| Limits and exclusions apply: Non-preferred brand drugs | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: 35% Coinsurance after deductible | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: 40% Coinsurance after deductible | ||
| Out of Network: 50% Coinsurance after deductible | ||
| Specialty drugs | Specialty drugs | Specialty drugs |
| Limits and exclusions apply: Specialty drugs | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: 45% Coinsurance after deductible | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| In Network Tier 2: 45% Coinsurance after deductible | ||
| Out of Network: 45% Coinsurance after deductible | ||
| Emergency room care | Emergency room care | Emergency room care |
| Limits and exclusions apply: Emergency room care | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 1: $950 Copay with deductible/40% Coinsurance after deductible | Out of Network: No Charge After Deductible | Out of Network: No Charge After Deductible |
| In Network Tier 2: Not Applicable | ||
| Out of Network: $950 Copay with deductible/40% Coinsurance after deductible | ||
| Inpatient doctor and surgical services | Inpatient doctor and surgical services | Inpatient doctor and surgical services |
| In Network Tier 1: 40% Coinsurance after deductible | In Network: No Charge After Deductible | In Network: No Charge After Deductible |
| In Network Tier 2: Not Applicable | Out of Network: Benefit Not Covered | Out of Network: Benefit Not Covered |
| Out of Network: 50% Coinsurance after deductible | ||
| Inpatient hospital services (like a hospital stay) | Inpatient hospital services (like a hospital stay) | Inpatient hospital services (like a hospital stay) |
| Limits and exclusions apply: Inpatient hospital services (like a hospital stay) | Limits and exclusions apply: Inpatient hospital services (like a hospital stay) | Limits and exclusions apply: Inpatient hospital services (like a hospital stay) |
| In Network Tier 1: $850 Copay per Stay with deductible/40% Coinsurance after deductible | ||
| In Network Tier 2: Not Applicable | ||
| Out of Network: $1500 Copay per Stay with deductible/50% Coinsurance after deductible |
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