Insurance

Patient insurance information and coverage

Blue Cross Blue Shield

Primary Insurance Provider

Active

Sarah Johnson

BCBS-2024-88921

GRP-5678901

January 1, 2024

December 31, 2024

$25 (Primary Care) / $45 (Specialist)

Deductible Status

Individual Deductible $1,500 / $2,500

$1,000 remaining to meet deductible

Out-of-Pocket Maximum $3,200 / $6,000

$2,800 remaining until maximum

Coverage Summary

Office Visits
80% covered
Prescriptions
90% covered
Imaging (X-Ray, MRI)
70% covered
Lab Work
100% covered

Recent Claims

View All
Service Date Provider Amount Status
Annual Physical Nov 15, 2024 Dr. Sarah Smith $150.00 Processed
Lab Work - Blood Panel Nov 15, 2024 Quest Diagnostics $85.00 Pending
X-Ray - Chest Oct 22, 2024 Metro Imaging $210.00 Processed

Aetna Medicare

Secondary Insurance Provider

Secondary

Sarah Johnson

AET-MED-445566

January 1, 2024

Medicare Supplement Plan G