Bridge Blue Point of Service (POS) (2021)

Bridge Blue Point of Service* is a Short-Term Medical plan that uses our HMO/POS network, an established network of quality doctors and hospitals throughout the state. Deductible and copayment plan options are available. For copayment plans, you pay a set copayment for most benefits when you get care from an HMO/POS network provider.

  • Available statewide

HMO/POS

NETWORK

=

Bridge Blue POS

PLAN

Here are some plan features and benefits:


Medical and Prescription Drug coverage for up to 11 months.


Coverage can begin as soon as the first day of the next month, pending application approval.


We pay 100 percent of preventive care services in network, excluding contraceptive drugs and devices.


Provides coverage for a range of treatments, including office visits, emergency services, hospitalization, lab tests, blood work, X-rays and mental healthcare.


Pediatric dental and vision coverage are excluded.


Two- or three-tier prescription drug coverage based on the plan you choose.


Drug deductibles are $1,000 or subject to the medical deductible, depending on the plan you buy.


Separate maternity deductible of $7,500 or $9,000 (In-Network), depending on the plan you buy, and $15,000 (Out-of-Network) that does not apply to the max out-of-pocket total.

Plan Name

Bridge Blue POS
70/50 $6,000

Bridge Blue POS
80/60 $3,400

Bridge Blue POS Copay 70/50 $4,500

Bridge Blue POS Copay 70/50 $9,000

Here are the basics:
Deductible (single) $6,000 $3,400 $4,500 $9,000
Most you pay out of pocket (single) $7,900 $7,900 $7,900 $15,800
Coinsurance we pay in network 70% 80% 70% 70%
Coinsurance you pay in network 30% 20% 30% 30%
Coinsurance we pay out of network 50% 60% 50% 50%
Coinsurance you pay out of network 50% 40% 50% 50%
What you'll pay if you go to the following places:
If you go to Primary Care doctor, you pay Deductible then 30% coinsurance Deductible then 20% coinsurance $40 per visit $45 per visit
QBPC, you pay Deductible then 30% coinsurance Deductible then 20% coinsurance $40 per visit $45 per visit
Specialist, you pay Deductible then 30% coinsurance Deductible then 20% coinsurance $60 per visit $65 per visit
Urgent Care, you pay Deductible then 30% coinsurance Deductible then 20% coinsurance $60 per visit $65 per visit
Outpatient ambulatory surgical center, you pay Deductible then 30% coinsurance Deductible then 20% coinsurance Deductible then 30% coinsurance Deductible then 30% coinsurance
Emergency room Deductible then 30% coinsurance; waived if admitted Deductible then 20% coinsurance; waived if admitted Deductible then 30% coinsurance; waived if admitted Deductible then 30% coinsurance; waived if admitted
Admitted as inpatient to hospital, you pay Deductible then 30% coinsurance Deductible then 20% coinsurance Deductible then 30% coinsurance Deductible then 30% coinsurance
What you'll pay for prescription drugs and other medical services:
Drug deductible per member The medical and drug deductible is integrated   The medical and drug deductible is integrated  $1,000 The medical and drug deductible is integrated 
Prescription drugs per fill, you pay

Tier 1: Medical deductible then 30% Generic coinsurance

Tier 2: Medical deductible then 50% Brand coinsurance

 

Tier 1: Medical deductible then 20% Generic coinsurance

Tier 2: Medical deductible then 40% Brand coinsurance

 

Tier 1: Generic Drug deductible then $15 copay

Tier 2: Preferred Brand Drug deductible then 20% coinsurance ($250 max)

Tier 3: Non-preferred Brand Drug deductible then 30% coinsurance ($250 max)

 

Tier 1: Medical deductible then 30% Generic coinsurance

Tier 2: Medical deductible then 50% Brand coinsurance
Preventive care services Fully Covered; excludes contraceptives Fully Covered; excludes contraceptives Fully Covered; excludes contraceptives Fully Covered; excludes contraceptives
Pregnancy care office visit Separate Maternity deductible of $7,500 then 30% coinsurance
Separate Maternity deductible of $7,500 then 20% coinsurance Separate Maternity deductible of $7,500 then 30% coinsurance Separate Maternity deductible of $9,000 then 30% coinsurance
Physical, occupational, speech therapy rehabilitation services Deductible then 30% coinsurance; Maximum $5,000 limit per benefit period Deductible then 20% coinsurance; Maximum $5,000 limit per benefit period $40 per visit; Maximum $5,000 limit per benefit period $45 per visit; Maximum $5,000 limit per benefit period
Mental health and substance use disorder (office visit) Deductible then 30% coinsurance  Deductible then 20% coinsurance  $40 per visit $45 per visit
Mental health and substance use disorder (inpatient) Deductible then 30% coinsurance Deductible then 20% coinsurance Deductible then 30% coinsurance Deductible then 30% coinsurance
Mental health and substance use disorder (outpatient) Deductible then 30% coinsurance Deductible then 20% coinsurance Deductible then 30% coinsurance Deductible then 30% coinsurance
Pediatric dental and vision Excluded

Plan Name

Bridge Blue POS 70/50 $6,000

Here are the basics
Deductible (single) $6,000
Most you pay out of pocket (single) $7,900
Coinsurance we pay in network 70%
Coinsurance you pay in network 30%
Coinsurance we pay out of network 50%
Coinsurance you pay out of network 50%
What you'll pay if you go to the following places:
If you go to Primary Care doctor, you pay Deductible then 20% coinsurance
QBPC, you pay Deductible then 20% coinsurance
Specialist, you pay Deductible then 20% coinsurance
Urgent Care, you pay Deductible then 20% coinsurance
Outpatients ambulatory surgical center, you pay Deductible then 20% coinsurance
Emergency room Deductible then 20% coinsurance; waived if admitted
Admitted as inpatient to hospital, you pay Deductible then 20% coinsurance
What you'll pay for prescription drugs and other medical services:
Drug deductible per member The medical and drug deductible is integrated  
Prescription drugs per fill, you pay

Tier 1: Medical deductible then 30% Generic coinsurance

Tier 2: Medical deductible then 50% Brand coinsurance

 

Preventive care services Fully Covered; excludes contraceptives
Pregnancy care office visit Separate Maternity deductible of $7,500 then 30% coinsurance
Physical, occupational, speech therapy rehabilitation services Deductible then 30% coinsurance; Maximum $5,000 limit per benefit period
Mental health and substance use disorder (inpatient & outpatient) Deductible then 30% coinsurance 
Mental health and substance use disorder (inpatient & outpatient) Deductible then 30% coinsurance
Mental health and substance use disorder (inpatient & outpatient) Deductible then 30% coinsurance
Pediatric dental and vision Excluded

Plan Name

Bridge Blue POS 80/60 $3,400

Here are the basics
Deductible (single) $3,400
Most you pay out of pocket (single) $7,900
Coinsurance we pay in network 80%
Coinsurance you pay in network 20%
Coinsurance we pay out of network 60%
Coinsurance you pay out of network 40%
What you'll pay if you go to the following places:
If you go to Primary Care doctor, you pay $45 per visit
QBPC, you pay $45 per visit
Specialist, you pay $65 per visit
Urgent Care, you pay $65 per visit
Outpatients ambulatory surgical center, you pay Deductible then 20% coinsurance
Emergency room Deductible then 30% coinsurance; waived if admitted
Admitted as inpatient to hospital, you pay Deductible then 30% coinsurance
What you'll pay for prescription drugs and other medical services:
Drug deductible per member The medical and drug deductible is integrated 
Prescription drugs per fill, you pay

Tier 1: Medical deductible then 20% Generic coinsurance

Tier 2: Medical deductible then 40% Brand coinsurance

 

Preventive care services Fully Covered; excludes contraceptives
Pregnancy care office visit Separate Maternity deductible of $7,500 then 20% coinsurance
Physical, occupational, speech therapy rehabilitation services Deductible then 20% coinsurance; Maximum $5,000 limit per benefit period
Mental health and substance use disorder (inpatient & outpatient) Deductible then 20% coinsurance 
Mental health and substance use disorder (inpatient & outpatient) Deductible then 20% coinsurance
Mental health and substance use disorder (inpatient & outpatient) Deductible then 20% coinsurance
Pediatric dental and vision Excluded

Plan Name

Bridge Blue POS Copay 70/50 $4,500

Here are the basics
Deductible (single) $4,500
Most you pay out of pocket (single) $7,900
Coinsurance we pay in network 70%
Coinsurance you pay in network 30%
Coinsurance we pay out of network 50%
Coinsurance you pay out of network 50%
What you'll pay if you go to the following places:
If you go to Primary Care doctor, you pay $40 per visit
QBPC, you pay $40 per visit
Specialist, you pay $60 per visit
Urgent Care, you pay $60 per visit
Outpatients ambulatory surgical center, you pay Deductible then 30% coinsurance
Emergency room Deductible then 30% coinsurance; waived if admitted
Admitted as inpatient to hospital, you pay Deductible then 30% coinsurance
What you'll pay for prescription drugs and other medical services:
Drug deductible per member $1,000
Prescription drugs per fill, you pay

Tier 1: Generic Drug deductible then $15 copay

Tier 2: Preferred Brand Drug deductible then 20% coinsurance ($250 max)

Tier 3: Non-preferred Brand Drug deductible then 30% coinsurance ($250 max)

 

Preventive care services Fully Covered; excludes contraceptives
Pregnancy care office visit Separate Maternity deductible of $7,500 then 30% coinsurance
Physical, occupational, speech therapy rehabilitation services $40 per visit; Maximum $5,000 limit per benefit period
Mental health and substance use disorder (inpatient & outpatient) $40 per visit
Mental health and substance use disorder (inpatient & outpatient) Deductible then 30% coinsurance
Mental health and substance use disorder (inpatient & outpatient) Deductible then 30% coinsurance
Pediatric dental and vision Excluded

Plan Name

Bridge Blue POS Copay 70/50 $9,000

Here are the basics
Deductible (single) $9,000
Most you pay out of pocket (single) $15,800
Coinsurance we pay in network 70%
Coinsurance you pay in network 30%
Coinsurance we pay out of network 50%
Coinsurance you pay out of network 50%
What you'll pay if you go to the following places:
If you go to Primary Care doctor, you pay Deductible then 30% coinsurance
QBPC, you pay Deductible then 30% coinsurance
Specialist, you pay Deductible then 30% coinsurance
Urgent Care, you pay Deductible then 30% coinsurance
Outpatients ambulatory surgical center, you pay Deductible then 30% coinsurance
Emergency room Deductible then 30% coinsurance; waived if admitted
Admitted as inpatient to hospital, you pay Deductible then 30% coinsurance
What you'll pay for prescription drugs and other medical services:
Drug deductible per member The medical and drug deductible is integrated 
Prescription drugs per fill, you pay

Tier 1: Medical deductible then 30% Generic coinsurance

Tier 2: Medical deductible then 50% Brand coinsurance
Preventive care services Fully Covered; excludes contraceptives
Pregnancy care office visit Separate Maternity deductible of $9,000 then 30% coinsurance
Physical, occupational, speech therapy rehabilitation services $45 per visit; Maximum $5,000 limit per benefit period
Mental health and substance use disorder (inpatient & outpatient) $45 per visit
Mental health and substance use disorder (inpatient & outpatient) Deductible then 30% coinsurance
Mental health and substance use disorder (inpatient & outpatient) Deductible then 30% coinsurance
Pediatric dental and vision Excluded

*Bridge Blue POS plans are products of HMO Louisiana, Inc., a subsidiary of Blue Cross and Blue Shield of Louisiana. Both companies are independent licensees of the Blue Cross and Blue Shield Association. Blue Cross and Blue Shield of Louisiana is incorporated as Louisiana Health Service & Indemnity Company.