Blue Value Plan 3000 is our most popular plan!

These rates are available for applicants enrolling July 1, 2009 through September 30, 2009.

Blue Value Plan 3000 is a lower cost plan that protects you from big medical expenses like hospital stays and gives you coverage for everyday worries like doctor visits and prescription drugs. And through 360º Health, you have access to wellness information resources along with case and care management services, all designed to help you achieve better health.

RATES - AREAS 1 & 2 - Use these rates if you live in Baldwin, Barrow, Bartow, Ben Hill, Berrien, Bibb, Bleckley, Brooks, Burke, Butts, Calhoun, Cherokee, Clarke, Clayton, Cobb, Colquitt, Columbia, Cook, Coweta, Crawford, Crisp, Dekalb, Dodge, Dougherty, Douglas, Elbert, Emanuel, Fayette, Forsyth, Fulton, Glascock, Grady, Greene, Gwinnett, Hancock, Henry, Houston, Irwin, Jackson, Jasper, Jefferson, Jenkins, Johnson, Jones, Laurens, Lanier, Lee, Lincoln, Lowndes, McDuffie, Madison, Montgomery, Monroe, Morgan, Newton, Oconee, Oglethorpe, Paulding, Peach, Pulaski, Putnam, Randolph, Richmond, Rockdale, Screven, Spalding, Taliaferro, Telfair, Terrell, Thomas, Tift, Treutlen, Turner, Twiggs, Walton, Warren, Washington, Wheeler, Wilcox, Wilkinson, Wilkes, and Worth Counties

BLUE VALUE
PLAN 3,000

Age

Male

Female

Family

0-19

$89.09

$89.09

$383.19

20-24

96.11

120.62

427.02

25-29

115.24

145.70

491.79

30-34

122.25

187.22

566.28

35-39

155.99

220.96

522.55

40-44

182.22

241.14

510.92

45-49

234.99

295.75

595.69

50-54

287.85

324.37

652.88

55-59

358.49

367.52

730.92

60-64

500.44

439.90

881.23

65+

500.44

439.90

881.23


RATES - AREA 3 - Use these rates if you live in Appling, Atkinson, Bacon, Baker, Banks, Brantley, Bryan, Bulloch, Camden, Candler, Carroll, Catoosa, Charlton, Chatham, Chattahoochee, Chattooga, Clay, Clinch, Coffee, Dade, Dawson, Decatur, Dooly, Early, Echols, Effingham, Evans, Fannin, Floyd, Franklin, Gilmer, Glynn, Gordon, Habersham, Hall, Haralson, Harris, Hart, Heard, Jeff Davis, Lamar, Liberty, Long, Lumpkin, McIntosh, Macon, Marion, Meriwether, Miller, Mitchell, Murray, Muscogee, Pickens, Pierce, Pike, Polk, Quitman, Rabun, Schley, Seminole, Stephens, Stewart, Sumter, Talbot, Tattnall, Taylor, Toombs, Towns, Troup, Union, Upson, Walker, Ware, Wayne, Webster, Whitfield or White County.

BLUE VALUE
PLAN 3,000

Age

Male

Female

Family

0-19

$81.97

$81.97

$352.54

20-24

88.42

110.97

392.86

25-29

106.02

134.05

452.45

30-34

112.47

172.24

520.98

35-39

143.51

203.28

480.75

40-44

167.65

221.85

470.05

45-49

216.19

272.07

548.03

50-54

264.82

298.42

600.65

55-59

329.81

338.12

672.44

60-64

460.41

404.70

810.73

65+

559.79

493.39

932.58

Blue Value Plan 3000 Benefits:

  • Plan Type: PPO
  • Calendar Year Deductible In-network: $3000
  • Calendar Year Deductible Out-of-network: $6000
  • Calendar Year Coinsurance Maximum In-network: $2000
  • Calendar Year Coinsurance Maximum Out-of-network: No limit
  • Coinsurance In-network: Plan pays 70%
  • Coinsurance Out-of-network: Plan pays 60%
  • Physician Choice: You choose specialist(s)
  • Physician Office Visit In-network: $40 copay for first 6 visits not subject to calendar year deductible; After 6 visits, Plan pays 70% after deductible is met
  • Physician Office Visit Out-of-network: Plan pays 60% after deductible is met
  • Prescription Drugs: Calendar Year Prescription Drug Deductible: $300; Generic Formulary: $15; Brand Formulary: $30; Non-Formulary: $45
  • Preventive Care Adults In-network: Plan pays 70%
  • Preventive Care Adults Out-of-network: Plan pays 60%
  • Preventive Care Children In-network: Plan pays 70%
  • Preventive Care Children Out-of-network: Plan pays 60%
  • Lab/X-ray, Surgery, Radiation, Anesthesia In-network: Plan pays 70%
  • Lab/X-ray, Surgery, Radiation, Anesthesia Out-of-network: Plan pays 60%
  • Outpatient Care In-network: Plan pays 70%
  • Outpatient Care Out-of-network: Plan pays 60%
  • Hospital Inpatient Services In-network: Plan pays 70%
  • Hospital Inpatient Services Out-of-network: Plan pays 60%
  • Physical/Occupational Therapy, Chiropractic In-network: Plan pays 70%, 30 visits per specialty per year
  • Physical/Occupational Therapy, Chiropractic Out-of-network: Plan pays 60%, per specialty per year
  • Behavioral Health/Substance Abuse Hospital Inpatient: $100 per day; $3000 calendar year maximum; $10,000 lifetime maximum
  • Behavioral Health/Substance Abuse Outpatient: Not covered
  • Maternity Physician In-network: Plan pays 100%
  • Maternity Physician Out-of-network: Plan pays 70%
  • Maternity Facility In-network: $3,000 copay then Plan pays 100%
  • Maternity Facility Out-of-network: $3,000 copay then Plan pays 70%
  • Emergency Room Copayment: $150
  • Emergency Room Medical Emergency or Accident: Plan pays 100% after $150 copay; Not subject to calendar year deductible
  • Emergency Room Non-Medical Emergency or Non-Serious Accidental Injury: Plan pays 70% in-network and 60% out-of-network after $150 copay and deductible is met
  • Speech Therapy, Respiratory Therapy, Skilled Care: Plan pays 70% in-network, Plan pays 60% out-of-network, limited to 30 visits per specialty per year

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Blue Cross Blue Shield of Georgia
Blue Value Plan 3000
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