BlueCare Dental℠ 1B - 33602TX0500002 Health Insurance Plan

Blue Cross Blue Shield of Texas health insurance plan with the Plan ID 33602TX0500002. The plan is called BlueCare Dental℠ 1B.

Health Insurance Plan ID 33602TX0500002
Health Insurance Plan Year 2024
State Texas
Health Insurance Issuer Blue Cross Blue Shield of Texas
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 33602TX0500002-01
Provider Network(s) PREFERRED
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 03 Dec 2024 06:24 GMT).

Providers Texas All US States
All 5215 55158
PCP 4 104
Allergy N/A N/A
OB/GYN N/A 1
Dentists 19 176
Available Variants of the Health Plan

Standard Off Exchange Plan - 33602TX0500002-00

Standard On Exchange Plan - 33602TX0500002-01

Last Plan Update Date Fri, 01 Dec 2023 00:00 GMT
Last Import Date Tue, 03 Dec 2024 06:24 GMT

Benefits of BlueCare Dental℠ 1B Health Insurance Plan, 33602TX0500002-01

Benefit Covered In Network Out Of Network
Accidental Dental

Procedures in this category may be subject to other coinsurance levels depended on services rendered.

YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Basic Dental Care - Adult
YES

30.00% Coinsurance after deductible

30.00% Coinsurance after deductible
Basic Dental Care - Child
YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Dental Check-Up for Children

Limit: 1.0 Visit(s) per 6 Months

YES

20.00%

20.00%
Major Dental Care - Adult
YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Major Dental Care - Child
YES

50.00% Coinsurance after deductible

50.00% Coinsurance after deductible
Orthodontia - Adult
NO
Orthodontia - Child
YES

50.00%

50.00%
Routine Dental Services (Adult)

Limit: 1.0 Visit(s) per 6 Months

YES

10.00%

10.00%

BlueCare Dental℠ 1B Health Insurance Plan Variant 33602TX0500002-01 Attributes

Plan Attribute Value
Begin Primary Care Cost-Sharing After Number Of Visits 0
Begin Primary Care Deductible Coinsurance After Number Of Copays 0
Business Year 2024
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Low On Exchange Plan
Dental Only Plan Yes
EHB Apportionment for Pediatric Dental 1.0
First Tier Utilization 100%
HIOS Product ID 33602TX050
Import Date 2023-12-01 01:01:56
Inpatient Copayment Maximum Days 0
Guaranteed Rate Guaranteed Rate
New/Existing Plan Existing
Issuer ID 33602
Issuer Marketplace Marketing Name Blue Cross and Blue Shield of Texas
Market Coverage Individual
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group $800 per group
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person $400 per person
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out $400
Medical EHB Deductible, Combined In/Out of Network, Family Per Group per group not applicable
Medical EHB Deductible, Combined In/Out of Network, Family Per Person per person not applicable
Medical EHB Deductible, Combined In/Out of Network, Individual Not Applicable
Medical EHB Deductible, In Network (Tier 1), Family Per Group $150 per group
Medical EHB Deductible, In Network (Tier 1), Family Per Person $50 per person
Medical EHB Deductible, In Network (Tier 1), Individual $50
Medical EHB Deductible, Out of Network, Family Per Group $150 per group
Medical EHB Deductible, Out of Network, Family Per Person $50 per person
Medical EHB Deductible, Out of Network, Individual $50
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual Not Applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Person per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual Not Applicable
Metal Level Low
Multiple In Network Tiers No
National Network Yes
Network ID TXN003
Out of Country Coverage Yes
Out of Country Coverage Description This Plan does not cover any services and/or supplies provided to a Member outside the United States if the Member traveled to the location for the purposes of receiving medical services, supplies, or drugs.
Out of Service Area Coverage Yes
Out of Service Area Coverage Description When accessing care outside our service area, you will obtain care from healthcare Providers that have a contractual agreement (i.e., are Participating Providers) with the local Blue Cross and/or Blue Shield Licensee in that other geographic area (Host Blue). In some instances, you may obtain care from Non-Participating Providers.
Plan Brochure URL
Plan Effective Date 2024-01-01
Plan ID (Standard Component ID with Variant) 33602TX0500002-01
Plan Marketing Name BlueCare Dental℠ 1B
Plan Type PPO
Plan Variant Marketing Name BlueCare Dental℠ 1B
QHP/Non QHP Both
Service Area ID TXS003
Source Name HIOS
Plan ID 33602TX0500002
State Code TX
URL for Enrollment Payment URL

Copay & Coinsurance of BlueCare Dental℠ 1B Health Insurance Plan, 33602TX0500002

Drug Tier Pharmacy Type Copay amount Copay option Coinsurance rate Coinsurance option Mail Order

Frequently Asked Questions(FAQ) about BlueCare Dental℠ 1B, 33602TX0500002 Health Insurance Plan, 33602TX0500002

  • Does BlueCare Dental℠ 1B Health Insurance Plan, 33602TX0500002 support Mail Ordering?

    Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.

  • Does (33602TX0500002) Health Insurance Plan, Variant (33602TX0500002-01) have Out Of Country Coverage?

    Yes. Details: This Plan does not cover any services and/or supplies provided to a Member outside the United States if the Member traveled to the location for the purposes of receiving medical services, supplies, or drugs.

    Does (33602TX0500002) Health Insurance Plan, Variant (33602TX0500002-01) have Out of Service Area Coverage?

    Yes. Details: When accessing care outside our service area, you will obtain care from healthcare Providers that have a contractual agreement (i.e., are Participating Providers) with the local Blue Cross and/or Blue Shield Licensee in that other geographic area (Host Blue). In some instances, you may obtain care from Non-Participating Providers.

 

Disclaimer: This is based on the import(Date: Tue, 03 Dec 2024 06:24 GMT) of the data from Healthcare Issuers listed by CMS. While we make every effort to ensure that data is accurate, you should assume all results are unvalidated. Source: CMS.gov, HealthPorta HEALTHCARE MRF API