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Blue Cross Blue Shield Therapy Cost
Co-pay Option - Separate Medical and Prescription Drug Deductible. Therapy Services - Includes chemotherapy, gene therapy, immunotherapy. Blue Cross & Blue Shield of Mississippi does not control such third party websites and is not responsible for the content, advice, products. $25 Physical Therapy and Occupational Therapy $15 Speech Therapy: Hospital Choice Cost Share — Save up to 16 percent off current costs. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association.

Blue Cross Blue Shield Therapist Cost
| In-Network (PPO benefit) - You pay: | Out-of-Network (Non-PPO benefit)* - You pay: | |
|---|---|---|
| Preventive Care | Nothing for covered preventive screenings, immunizations and services | 35% of our allowance† |
| Physician Care | $25 for primary care | 35% of our allowance† |
| Virtual Doctor Visits by Teladoc® | $0 for first 2 visits | N/A |
| Urgent Care Center | Accidental Injury: $0 Medical Emergency: $30 copay | Accidental Injury: $0 Medical Emergency: 35% of our allowance† |
| Prescription Drugs | Preferred Retail Pharmacy: Tier 1 (Generics): $7.50 copay1 Tier 2 (Preferred brand): 30% of our allowance Tier 3 (Non-preferred brand): 50% of our allowance Tier 4 (Preferred specialty): 30% of our allowance Tier 5 (Non-preferred specialty): 30% of our allowance Mail Service Pharmacy: Tier 1 (Generics): $15 copay1 Tier 2 (Preferred brand): $90 copay Tier 3 (Non-preferred brand): $125 copay Specialty Pharmacy2: Tier 4 (Preferred specialty): $65 copay Tier 5 (Non-preferred specialty): $85 copay | Retail Pharmacy: 45% of our allowance Mail Service Pharmacy: Not covered Specialty Pharmacy: Not covered |
| Maternity Care | $0 copay | Pre-/postnatal professional care: 35% of our allowance† Inpatient hospital: $450 per admission copay for unlimited days, plus 35% of our allowance Outpatient facility care: 35% of our allowance† |
| Hospital Care | Inpatient (Precertification is required): $350 per admission Outpatient: 15% of our allowance† | Inpatient (Precertification is required): $450 per admission copay, plus 35% of our allowance Outpatient: 35% of our allowance† |
| Surgery | 15% of our allowance† | 35% of our allowance† |
| ER (accidental injury) | $0 within 72 hours | Nothing for covered services |
| ER (medical emergency) | 15% of our allowance† | 15% of our allowance† |
| Lab work (such as blood tests) | 15% of our allowance† | 35% of our allowance† |
| Diagnostic services (such as sleep studies, X-rays, CT scans) | 15% of our allowance† | 35% of our allowance† |
| Chiropractic Care | $25 per treatment; up to 12 visits per year | 35% of our allowance†; up to 12 visits per year |
| Dental Care | The difference between the fee schedule amount and the Maximum Allowable Charge (MAC) | 35% of our allowance† |
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