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Anthem / Blue Cross Blue ShieldAnthem / Blue Cross Blue Shield

Sterling Dual Network

Anthem / Blue Cross Blue Shield

Sterling Dual Network — Deductible: $2,000 / $3,000; Max Out of Pocket: $7,500 / $18,200; Office Copays: $35 / $40; X-Ray & Bloodwork: After deductible; Advanced Imaging: After deductible.

Monthly premiums

Member
$1,375.00/mo
Member & Children
$2,425.00/mo
Member & Spouse
$2,545.00/mo
Member & Family
$3,045.00/mo

Plan details

Deductible (Individual)
$2,000
Deductible (Family)
$4,000
Out-of-Pocket Max (Individual)
$7,500
Out-of-Pocket Max (Family)
$18,200
Primary Care Copay
$35
Specialist Copay
$45
Urgent Care Copay
$75

Benefits

  • Deductible

    $2,000 / $3,000

    Tier 1 (Northwell) / Tier 2 (BlueCard) · OON $6,000

  • Max Out of Pocket

    $7,500 / $18,200

    Individual / Family

  • Office Copays

    $35 / $45

    PCP / Specialist (Tier 1)

  • X-Ray & Bloodwork

    After deductible

    Minor services (in-network)

  • Advanced Imaging

    After deductible

    CT / MRI / PET

  • Emergency Room

    Deductible then $800

    Per visit

  • Urgent Care

    $75 copay

    In-network

  • Hospital Stay

    Deductible then $700/admission

    Facility (Tier 1)

  • Mental Health

    Deductible then $45 copay

    Outpatient (Tier 1)

  • Maternity

    After deductible

    Delivery (Tier 1)

  • Rx Coverage

    Generic $10 / Preferred $60 / Non-Preferred $80

    After Rx deductible: $150 / $300 (waived on generics)

  • Dual Network

    Northwell Direct + BlueCard PPO

    Tier 1 (Northwell Direct) · Tier 2 (Anthem BlueCard PPO)

  • Virtual Care

    No charge

    CirrusMD 24/7

  • Referrals

    None required

    See any specialist

  • Preventive Care

    100% covered

    Before deductible

  • Eligibility

    Until age 59 · Must be working

Plan documents

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