Copy {
"plans": [
{
"hios_id": "53901AZ1490005",
"name": "Blue Portfolio HSA Gold Statewide PPO",
"issuer": {
"name": "Blue Cross and Blue Shield of Arizona",
"hios_id": "53901",
"state": "AZ",
"payment_phone": "8447292583",
"customer_service_phone": "6028644115",
"eap_disabled": true
},
"metal_level": "Gold",
"is_easy_pricing_plan": false,
"plan_type": "PPO",
"network_type": "PPO",
"adult_medical": true,
"child_medical": true,
"adult_dental": false,
"child_dental": true,
"referral_required_for_specialist": false,
"hsa_eligible": true,
"state": "AZ",
"dental_only": false,
"estimated_rate": false,
"networks": [
{
"id": 6028,
"name": "Statewide PPO",
"year": 2025,
"issuer_network_id": "AZN003"
}
],
"year": 2025,
"dentist_network_url": null,
"csr_code": "01",
"rating": {
"hios_issuer_id": "53901",
"state": "AZ",
"plan_type": "PPO",
"plan_year": 2025,
"global_rate": 4,
"s1_rate": 4,
"s2_rate": 5,
"s3_rate": 4
},
"cost_sharing": {
"network_tier": "inn",
"csr_type": "none",
"medical_ded_ind": "2500",
"medical_ded_fam": "5000",
"drug_ded_ind": "Included in Medical",
"drug_ded_fam": "Included in Medical",
"medical_moop_ind": "4500",
"medical_moop_fam": "9000",
"drug_moop_ind": "Included in Medical",
"drug_moop_fam": "Included in Medical",
"medical_coins": "20.00%",
"drug_coins": "Included in Medical",
"pcp_visit_free_count": 0,
"pcp_visit_ded_coins_begins_count": 0
},
"csr_level": "none",
"cost_sharing_pretty": {
"csr_type": "none",
"ded_med_ind": "$2500",
"ded_med_fam": "$5000",
"ded_drug_ind": "No charge",
"ded_drug_fam": "No charge",
"oop_med_ind": "$4500",
"oop_med_fam": "$9000",
"oop_drug_ind": "No charge",
"oop_drug_fam": "No charge"
},
"benefits": {
"chiropractic": "20% coinsurance after deductible",
"maternity": "20% coinsurance after deductible",
"hospice_services": "20% coinsurance after deductible",
"mental_health_outpatient": "20% coinsurance after deductible",
"phys_occ_therapy": "20% coinsurance after deductible",
"home_health_care_services": "20% coinsurance after deductible",
"outpatient_rehabilitation_services": "20% coinsurance after deductible",
"inpatient_physician": "20% coinsurance after deductible",
"emergency": "20% coinsurance after deductible",
"ambulance": "20% coinsurance after deductible",
"generic_rx": "20% coinsurance after deductible",
"imaging_advanced": "20% coinsurance after deductible",
"inpatient_facility": "20% coinsurance after deductible",
"lab_services": "20% coinsurance after deductible",
"mental_health_inpatient": "20% coinsurance after deductible",
"non_preferred_rx": "20% coinsurance after deductible",
"other_practitioner_office_visit": "20% coinsurance after deductible",
"outpatient_facility": "20% coinsurance after deductible",
"outpatient_physician": "20% coinsurance after deductible",
"preferred_rx": "20% coinsurance after deductible",
"prenatal_and_postnatal_care": "20% coinsurance after deductible",
"preventative": "No charge",
"primary_care": "20% coinsurance after deductible",
"skilled_nursing_facility": "20% coinsurance after deductible",
"specialist": "20% coinsurance after deductible",
"specialty_rx": "20% coinsurance after deductible",
"substance_abuse_disorder_inpatient": "20% coinsurance after deductible",
"substance_abuse_disorder_outpatient": "20% coinsurance after deductible",
"urgent_care": "20% coinsurance after deductible",
"well_baby": "No charge",
"imaging_xray": "20% coinsurance after deductible"
},
"benefits_with_tier_2": {
"chiropractic": false,
"maternity": false,
"hospice_services": false,
"mental_health_outpatient": false,
"phys_occ_therapy": false,
"home_health_care_services": false,
"outpatient_rehabilitation_services": false,
"inpatient_physician": false,
"emergency": false,
"ambulance": false,
"generic_rx": false,
"imaging_advanced": false,
"inpatient_facility": false,
"lab_services": false,
"mental_health_inpatient": false,
"non_preferred_rx": false,
"other_practitioner_office_visit": false,
"outpatient_facility": false,
"outpatient_physician": false,
"preferred_rx": false,
"prenatal_and_postnatal_care": false,
"preventative": false,
"primary_care": false,
"skilled_nursing_facility": false,
"specialist": false,
"specialty_rx": false,
"substance_abuse_disorder_inpatient": false,
"substance_abuse_disorder_outpatient": false,
"urgent_care": false,
"well_baby": false,
"imaging_xray": false
},
"benefits_pretty": {
"chiropractic": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"maternity": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"hospice_services": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"mental_health_outpatient": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"phys_occ_therapy": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"home_health_care_services": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"outpatient_rehabilitation_services": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"inpatient_physician": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"emergency": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"ambulance": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"generic_rx": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"imaging_advanced": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"inpatient_facility": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"lab_services": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"mental_health_inpatient": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"non_preferred_rx": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"other_practitioner_office_visit": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"outpatient_facility": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"outpatient_physician": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"preferred_rx": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"prenatal_and_postnatal_care": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"preventative": {
"original": "No charge",
"before": "No charge",
"after": "No charge"
},
"primary_care": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"skilled_nursing_facility": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"specialist": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"specialty_rx": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"substance_abuse_disorder_inpatient": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"substance_abuse_disorder_outpatient": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"urgent_care": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
},
"well_baby": {
"original": "No charge",
"before": "No charge",
"after": "No charge"
},
"imaging_xray": {
"original": "20% after deductible",
"before": "Full price",
"after": "20%"
}
},
"urls": {
"network": "https://www.azblue.com/ppo",
"benefits": "https://common.secure.azblue.com/SBC/GetSBC?ProductName=PPO%20Portfolio%20HSA%20Gold%20&Deductibles=2500&EffectiveDate=2025/01/01&ContractType=2.pdf",
"formulary": "https://www.azblue.com/blueexchangeselectformulary",
"brochure": "https://www.azblue.com/2025plans/IndividualShoppersGuide"
},
"cost_sharing_tiers": {
"inn": {
"network_tier": "inn",
"csr_type": "none",
"medical_ded_ind": "2500",
"medical_ded_fam": "5000",
"drug_ded_ind": "Included in Medical",
"drug_ded_fam": "Included in Medical",
"medical_moop_ind": "4500",
"medical_moop_fam": "9000",
"drug_moop_ind": "Included in Medical",
"drug_moop_fam": "Included in Medical",
"medical_coins": "20.00%",
"drug_coins": "Included in Medical"
},
"inn2": "No data available",
"oon": {
"network_tier": "oon",
"csr_type": "none",
"medical_ded_ind": "9000",
"medical_ded_fam": "18000",
"drug_ded_ind": "Included in Medical",
"drug_ded_fam": "Included in Medical",
"medical_moop_ind": "18000",
"medical_moop_fam": "36000",
"drug_moop_ind": "Included in Medical",
"drug_moop_fam": "Included in Medical",
"medical_coins": null,
"drug_coins": null
}
},
"benefits_explanations": {
"primary_care": "24/7 online doctor visits available with BlueCare Anywhere - see SBC for more information.",
"specialist": null
},
"gross_premium": 775.14,
"ehb_premium": 775.14,
"subsidy_applied": 42,
"premium": 733.14,
"gross_premium_per_applicant": {
"dependents": [],
"non_dependents": {
"primary": 775.14
},
"excluded_dependents": 0
},
"attributes": [
{
"text": "High monthly premium payment",
"type": "bad",
"rank": 101,
"total": 101,
"value": [
733.14,
2500
],
"category": "premium"
},
{
"text": "Average deductible",
"type": "avg",
"rank": 40,
"total": 32,
"value": 2500,
"category": "deductible"
},
{
"text": "Low out of pocket maximum",
"type": "good",
"rank": 2,
"total": 25,
"value": 4500,
"category": "moop"
},
{
"text": "High worst case costs",
"type": "bad",
"rank": 84,
"total": 100,
"value": 13297.68,
"category": "worst_case"
},
{
"text": "High cost for primary care doctor visits",
"type": "bad",
"rank": 101,
"total": 13,
"value": 186.3,
"category": "primary_care_cost"
},
{
"text": "High cost for specialist visits",
"type": "bad",
"rank": 101,
"total": 15,
"value": 207,
"category": "specialist_cost"
},
{
"text": "Average cost for emergency room visits",
"type": "avg",
"rank": 39,
"total": 12,
"value": 1209.8,
"category": "emergency_room"
},
{
"text": "Average cost for hospital stays",
"type": "avg",
"rank": 58,
"total": 33,
"value": 6858,
"category": "hospital_stay"
},
{
"text": "Average cost for generic drugs",
"type": "avg",
"rank": 89,
"total": 9,
"value": 28.75,
"category": "generic_drug"
},
{
"text": "High cost for approved brand name drugs",
"type": "bad",
"rank": 101,
"total": 14,
"value": 299,
"category": "brand_drug"
},
{
"text": "Covers dental services for children",
"type": "good",
"rank": null,
"total": 101,
"value": true,
"category": "child_dental"
},
{
"text": "Health Savings Account (HSA) eligible",
"type": "good",
"rank": null,
"total": 101,
"value": true,
"category": "hsa"
}
],
"providers": [],
"drugs": [],
"prescriptions": {},
"medicaid_eligible_applicants": [],
"id": "1",
"deductible": 2500,
"moop": 4500,
"issuer_name": "Blue Cross and Blue Shield of Arizona"
}
],
"meta": {
"result_count": 25
}
}