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Medical Plans - Statewide PPO Network

All of our plans are available with our extensive BCBSAZ statewide provider network. A few plans are also available at a lower cost with one of our two High Performance Networks, called “Alliance” and “Select.” If you choose the Alliance or Select network, most Arizona in-network doctors and hospitals are located in Maricopa County. The contracted doctors and hospitals in the Alliance and Select networks are part of a smaller, more localized and more integrated network. This is how BCBSAZ lowers the cost of services, passing the savings on to you with lower premiums for plans with these High Performance Networks. If your doctors are in Maricopa County, there’s a good chance they’re in one of these two networks.

  • Alliance Network:The Alliance Network includes contracted hospitals and doctors that are part of Banner Health and Scottsdale Healthcare.
  • Select Network:The Select Network includes contracted hospitals and doctors that are part of Phoenix Children’s Hospital, Dignity Health, IASIS Healthcare, and Abrazo Health.

The below chart does not show all available plans or all differences between displayed plans. All plans have exclusions, limitations and cost share requirements.

EverydayHealth

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EverydayHealth plan offers fixed copays and fees for many of the healthcare services you and your family use most when you get services from an in-network provider. This includes doctor visits, urgent care, prescriptions, vision checks, and more. Choose from four plan options to match your budget. Networks Available: Statewide PPO, Alliance (Maricopa), Select (Maricopa). The plans below show the in-network benefits only.

 

Deductibles Available

Coinsurance

OOP Max

Office Visits

Prescription Medications

EverydayHealth 1000
Metal Level: Gold

View Individual Details
View Family Details

Individual: $1,000
Family: $2,000

20% after deductible

Individual: $4,500
Family: $9,000

Primary Care: $20
Specialist: $40

$15/$40/$80

EverydayHealth 3000
Metal Level: Silver

View Individual Details
View Family Details

Individual: $3,000
Family: $6,000

20% after deductible

Individual: $4,500
Family: $9,000

Primary Care: $30
Specialist: $60

$25/$50/$100

EverydayHealth 4000
Metal Level: Silver

View Individual Details
View Family Details

Individual: $4,000
Family: $8,000

20% after deductible

Individual: $6,350
Family: $12,700

Primary Care: $30
Specialist: $60

$15/$50/$100

EverydayHealth 6000
Metal Level: Bronze

View Individual Details
View Family Details

Individual: $6,000
Family: $12,000

20% after deductible

Individual: $6,350
Family: $12,700

Primary Care: $40
Specialist: $80

$25/$80/$160

Essential

Get A Quote

Many of your basic care needs are covered at a lower cost by having an Essential plan. This means you pay fixed copays for the first three in-network primary and specialist care office visits each year. You also have a set cost for in-network urgent care, eye checks, and most prescriptions. Choose one of four deductible options that fit your budget. Networks Available: Statewide PPO. The plans below show the in-network benefits only.

 

Deductibles Available

Coinsurance

OOP Max

Office Visits

Prescription Medications

Essential 1500
Metal Level: Gold

View Individual Details
View Family Details

Individual: $1,500
Family: $3,000

20% after deductible

Individual: $3,000
Family: $6,000

$25 for first 3 office visits then 20% after deductible

$15/$40/$90

Essential 3000
Metal Level: Silver

View Individual Details
View Family Details

Individual: $3,000
Family: $6,000

20% after deductible

Individual: $6,350
Family: $12,700

$30 for first 3 office visits then 20% after deductible

$15/$40/$90

Essential 4000
Metal Level: Silver

View Individual Details
View Family Details

Individual: $4,000
Family: $8,000

20% after deductible

Individual: $6,350
Family: $12,700

$25 for first 3 office visits then 20% after deductible

$10/$25/$50

Essential 6000
Metal Level: Bronze

View Individual Details
View Family Details

Individual: $6,000
Family: $12,000

30% after deductible

Individual: $6,350
Family: $12,700

$35 for first 3 office visits then 30% after deductible

$25/$60/$120

FitRewards

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With FitRewards, you get a plan that pays you back. Earn $20 each month you exercise regularly at your favorite gym. Just submit a form showing you went to a gym or fitness facility at least 8 times in a month and we’ll send you a check*. Your in-network primary care visits, eye exams and most prescriptions are covered at low copays too. Networks Available: Statewide PPO. The plans below show the in-network benefits only.

 

Deductibles Available

Coinsurance

OOP Max

Office Visits

Prescription Medications

FitRewards 1500*
Metal Level: Gold

View Individual Details
View Family Details

Individual: $1,500
Family: $3,000

30% after deductible

Individual: $3,000
Family: $6,000

Primary Care: $10
Specialist: 30% after deductible

$10/$55/$95

FitRewards 3000*
Metal Level: Silver

View Individual Details
View Family Details

Individual: $3,000
Family: $6,000

20% after deductible

Individual: $6,350
Family: $12,700

Primary Care: $15
Specialist: 20% after deductible

$15/$55/$110

FitRewards 4000*
Metal Level: Silver

View Individual Details
View Family Details

Individual: $4,000
Family: $8,000

20% after deductible

Individual: $6,350
Family: $12,700

Primary Care: $10
Specialist: 20% after deductible

$10/$45/$90

FitRewards 6000*
Metal Level: Bronze

View Individual Details
View Family Details

Individual: $6,000
Family: $12,000

30% after deductible

Individual: $6,350
Family: $12,700

Primary Care: $15
Specialist: 30% after deductible

$15/$90/$180

Portfolio

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Take charge of your own healthcare dollars like you do your budget. These high-deductible, low-premium Portfolio plans are designed to work with a Health Savings Account (HSA) from a qualified financial institution. Each of the four plans covers many in-network preventive care services at no charge. Select the deductible level that fits your budget. Networks Available: Statewide PPO. The plans below show the in-network benefits only.

 

Deductibles Available

Coinsurance

OOP Max

Office Visits

Prescription Medications

Portfolio 1500
Metal Level: Gold

View Individual Details
View Family Details

Individual: $1,500
Family: $3,000

10% after deductible

Individual: $3,000
Family: $6,000

Primary Care and Specialist office visits: 10% after deductible

10% after deductible

Portfolio 2500
Metal Level: Silver

View Individual Details
View Family Details

Individual: $2,500
Family: $5,000

20% after deductible

Individual: $4,500
Family: $9,000

Primary Care and Specialist office visits: 20% charge after deductible

20% after deductible

Portfolio 3500
Metal Level: Silver

View Individual Details
View Family Details

Individual: $3,500
Family: $7,000

After your deductible is met there will be no charge for additional services

Individual: $3,500
Family: $7,000

Primary Care and Specialist office visits: No charge after deductible

No charge after deductible

Portfolio 5500
Metal Level: Bronze

View Individual Details
View Family Details

Individual: $5,500
Family: $11,000

After your deductible is met there will be no charge for additional services

Individual: $5,500
Family: $11,000

Primary Care and Specialist office visits: No charge after deductible

No charge after deductible

CopayComplete

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When you need healthcare, it helps to know how much it will cost. With CopayComplete, you simply pay a set copayment for most covered service received from an in-network provider. This simple-to-use plan with $0 in-network deductible covers doctor visits, eye checks, prescriptions, diagnostic tests, and urgent, emergency and maternity care. Networks Available: Statewide PPO, Alliance (Maricopa), Select (Maricopa). The plans below show the in-network benefits only.

 

Deductibles Available

Coinsurance

OOP Max

Office Visits

Prescription Medications

CopayComplete 20
Metal Level: Gold

View Individual Details
View Family Details

Individual: $0
Family: $0

N/A

Individual: $6,350
Family: $12,700

Primary Care: $20
Specialist: $50

$15/$45/$90

CopayComplete 40
Metal Level: Silver

View Individual Details
View Family Details

Individual: $0
Family: $0

N/A

Individual: $6,350
Family: $12,700

Primary Care: $40
Specialist: $80

$25/$70/$160

SimpleHealth

Get A Quote

You’re never too young for health insurance. A SimpleHealth plan is great for members under age 30. provides coverage when you’re sick and helps you stay well, covering most in-network preventive care services at no out-of-pocket cost to you. This plan gives you three visits to your primary care doctor for a low copay. Many services are covered at no cost after you meet your deductible. Networks Available: Statewide PPO, Alliance (Maricopa), Select (Maricopa). The plans below show the in-network benefits only.

 

Deductibles Available

Coinsurance

OOP Max

Office Visits

Prescription Medications

SimpleHealth
Metal Level: Catastrophic

View Individual Details
View Family Details

Individual: $0
Family: $0

After your deductible is met there will be no charge for additional services

Individual: $6,350
Family: $12,700

Primary Care: $20 for the first 3 office visits.
Specialist: No charge after deductible

No charge after deductible

Disclaimer and Footnotes

Blue Cross Blue Shield of Arizona is a Qualified Health Plan issuer in the Health Insurance Marketplace.

This chart shows certain in-network cost share amounts. In-network cost share is what you pay for care from a provider who is part of the BCBSAZ network. Your cost share and deductible will be higher if you get care from an out-of-network provider.  Also, when you go out-of-network, you usually have to pay the difference between what the provider charges and the allowed amount (called “the balance bill”). For example: if an out-of-network hospital charges $1,500 for a service and the allowed amount is $1,000, you may have to pay the $500 difference, plus your out of network cost share.

Chart does not show all available plans or all differences between displayed plans. All plans have exclusions, limitations and cost share requirements

*FitReward’s ExerciseRewards® program is administered by American Specialty Health Fitness (ASHN). ASHN is an independent company that is contracted with BCBSAZ to administer the ExerciseRewards® program. For more information about the ASHN program, visit www.exerciserewards.com.

SimpleHealth is available only to people under age 30, or to people who receive an exemption from the individual mandate through the Health Insurance Marketplace.

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