Both Blue Cross Blue Shield PPO and UnitedHealthcare Choice Plus offer comprehensive health insurance options with national coverage. The best choice depends on individual needs, preferred cost structure, and the importance of specific benefits like telehealth or mental health services. BCBS PPO has a very large network, but UHC Choice Plus provides more plan options and potentially lower costs depending on the specific plan chosen.
| Attribute | Blue Cross Blue Shield PPO | UnitedHealthcare Choice Plus |
|---|---|---|
| Monthly Premium Cost | Varies, may qualify for premium tax credits | Varies based on location, plan design, and individual/family plan. |
| Deductible Amount (Individual/Family) | BCBS PPO Value plan: In-network $9,200 individual / $18,400 family, Out-of-network $18,400 individual / $36,800 family. Other plans: $1,000 individual / $2,500 family; $8,200 individual / $16,400 family; Participating $0 individual and family / Non-participating $15,000 individual / $45,000 family | Varies widely. Examples: $0 / $0 (Network) and $500 / $1,000 (Out-of-Network); $400 / $400 (Network) and $600 / $600 (Out-of-Network); $500 / $1,500 (Network); $750 / $2,250; $1,500 / $3,000; $2,000 / $6,000. |
| Out-of-Pocket Maximum (Individual/Family) | BCBS PPO Value plan: In-network $9,200 individual / $18,400 family, Out-of-network $18,400 individual / $36,800 family. Other plans: $8,200 individual / $16,400 family; Participating $900 individual / $1,800 family, Non-participating unlimited individual and family; In-network $6,700 member / $13,400 family, Out-of-network $13,400 member / $26,800 family | Varies significantly. Examples: $1,000 / $2,000 (includes deductible and copays); $3,000 / $6,000 (does not include the deductible); $4,000 / $8,000; $2,000 / $4,000 (Network) and $6,000 / $12,000 (Out-of-Network); $5,800 / $11,600 (Network) and $10,000 / $20,000 (Out-of-Network); $8,000 / $16,000. |
| Copay for Primary Care Physician Visit | BCBS PPO Value plan: $30 copay for first three visits to treat injury or illness | Varies; examples: $10, $20, $35, or no copay. |
| Copay for Specialist Visit | $30 copay for specialist office visits | Varies; examples: $20, $30, $40, $50 copay. |
| Prescription Drug Coverage (Formulary Tiers & Costs) | After deductible, no cost for covered prescriptions | Uses a formulary. Tiers and costs vary by plan. Some plans may have a separate prescription drug deductible. Some plans have $0 copays on hundreds of prescription drugs through Medicare Advantage plans. Mail-order options may be available. |
| In-network Coverage Area (State/Region) | All 50 states | National network of providers. |
| Out-of-network Coverage Details | Care from any provider, in or out of network. May be paid based on BCBS 'usual and customary' fee schedule | Offers coverage for out-of-network providers at a higher cost. Higher deductibles, copays, and coinsurance may apply. You may be responsible for amounts exceeding covered charges. |
| Preventive Care Coverage (e.g., Annual Checkups, Vaccinations) | Preventive care services covered without cost-sharing in-network | Generally covers preventive care services at 100% within the network. Includes annual checkups, vaccinations, pap smears, prenatal care, routine check-ups, childhood immunizations and mammograms. |
| Coverage for Mental Health Services | Included in most BCBS policies | Covers a wide range of mental health services, including therapy. Coverage includes outpatient therapy, group therapy, and family therapy. Often managed through United Behavioral Health (Optum). No referrals are required. |
| Coverage for Physical Therapy | Accepted at Houston Spine & Rehabilitation Centers | Coverage available. Some plans limit the number of outpatient therapy visits. |
| Availability of Telehealth Services | Available for mental health care remotely | Generally available. Some plans offer virtual visits with no charge through designated network providers. |