HMO Louisiana
Blue Connect 80/60 $3400 with 2 $0 PCP Virtual Visits (L)
Plan ID19636LA0240010
Plan year2027Sold on HealthCare.gov
Plan typePOSNo referral needed
Metal levelSilverNot HSA-eligible
Sold in8 countiesof 64 in Louisiana
Deductible$3,400$10,200 family
Out-of-pocket max$10,000$20,000 family
Primary care visit20% after deductiblein network
Generic drugs20% after deductibleper prescription
15,500 Louisiana doctors and facilities in this plan's network · Directory updated Nov 5, 2026 · Monthly premiums are not shown: they depend on age, county and income. NPI Profile does not sell insurance; HealthCare.gov lists premiums and handles enrollment.
Find a doctor in this plan
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Listed in HMO Louisiana's provider directory. Directories can be out of date, so call the office to confirm they take this plan.
What you pay with this plan
In-network costs for one person, from the CMS plan files for 2027. "After deductible" means you pay the full cost until you reach the $3,400 deductible.
Doctor visits
- Primary care visit
- 20% after deductible
- Specialist visit
- 20% after deductible
- Nurse practitioner or PA visit
- 20% after deductible
- Preventive care and vaccines
- Free
- Urgent care
- 20% after deductible
Prescription drugs
- Generic drugs
- 20% after deductible
- Preferred brand drugs
- 40% after deductible
- Non-preferred brand drugs
- 40% after deductible
- Specialty drugs
- 40% after deductible
Tests and imaging
- Lab work
- 20% after deductible
- X-rays
- 20% after deductible
- MRI, CT and PET scans
- 20% after deductible
Emergencies and hospital
- Emergency room
- 20% after deductible
- Ambulance
- 20% after deductible
- Hospital stay
- 20% after deductible
- Outpatient surgery (facility)
- 20% after deductible
Mental health
- Therapy and counseling visits
- 20% after deductible
- Inpatient mental health care
- 20% after deductible
Pregnancy
- Prenatal and postnatal care
- 20% after deductible
- Delivery and hospital stay
- 20% after deductible
Other care
- Physical and occupational therapy
- 20% after deductible
- Chiropractic care
- 20% after deductible
- Eye exam for childrenLimit: 1 visit a year
- Free
- Glasses for childrenLimit: 1 item a year
- Free
- Adult dental
- Not covered
$5,040Having a baby (CMS example)
$3,300Managing type 2 diabetes for a year
$2,800A simple fracture
Every service in the plan file (75)
| Service | You pay | Limits and notes |
|---|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered | |
| Accidental Dental | 20% after deductible | |
| Acupuncture | Not covered | |
| Allergy Testing | 20% after deductible | |
| Attention Deficit Disorder | 20% after deductible | |
| Bariatric Surgery | Not covered | |
| Basic Dental Care - Adult | Not covered | |
| Basic Dental Care - Child | 50% after deductible | |
| Chemotherapy | 20% after deductible | |
| Chiropractic Care | 20% after deductible | |
| Clinical Trials | 20% after deductible | The following services are not covered: a. Non-healthcare services provided as part of the clinical trial;b. Costs for managing research data associated with the clinical trial;c. Investigational drugs or devices; and/ord. Services, treatment or supplies not |
| Congenital Anomaly, including Cleft Lip/Palate | 20% after deductible | |
| Cosmetic Surgery | Not covered | |
| Delivery and All Inpatient Services for Maternity Care | 20% after deductible | |
| Dental Anesthesia | 20% after deductible | |
| Dental Check-Up for Children | Free | 1 visit every 6 months |
| Diabetes Care Management | 20% after deductible | |
| Diabetes Education | 20% after deductible | |
| Dialysis | 20% after deductible | |
| Durable Medical Equipment | 20% after deductible | Exclusions are but not limited to: hairpieces, wigs, hair growth, and/or hair implants; Personal comfort, personal hygiene and convenience items including, but not limited to, air conditioners, humidifiers, personal fitness equipment, or alterations to a |
| Emergency Room Services | 20% after deductible | |
| Emergency Transportation/Ambulance | 20% after deductible | No benefits are available if transportation is provided for the Member's comfort or convenience, or when a hospital transports members between parts of its own campus. |
| Eye Glasses for Children | Free | 1 item a year |
| Generic Drugs | 20% after deductible | Certain exclusion apply - Please see the contract book for a full list of pharmacy exclusions. |
| Habilitation Services | 20% after deductible | Other exclusions include but not limited to: Visual therapy; lifestyle/habit changing clinics and/or programs; recreational therapy; primarily to enhance athletic abilities; and/or inpatient pain rehabilitation and inpatient pain control programs |
| Hearing Aids | 20% after deductible | 1 item every 3 years Certain exclusion apply - Please see the contract book. Benefits are available for hearing aids for covered Members when obtained from a Network Provider or another Provider approved by Us. This Benefit is limited to one hearing aid, per |
| Home Health Care Services | 20% after deductible | |
| Hospice Services | 20% after deductible | |
| Imaging (CT/PET Scans, MRIs) | 20% after deductible | |
| Infertility Treatment | Not covered | |
| Infusion Therapy | 20% after deductible | |
| Inherited Metabolic Disorder - PKU | 20% after deductible | Exclusions are but not limited to: food or food supplements, formulas and medical foods, including those used for gastric tube feedings. |
| Inpatient Hospital Services (e.g., Hospital Stay) | 20% after deductible | |
| Inpatient Physician and Surgical Services | 20% after deductible | |
| Laboratory Outpatient and Professional Services | 20% after deductible | |
| Long-Term/Custodial Nursing Home Care | Not covered | |
| Major Dental Care - Adult | Not covered | |
| Major Dental Care - Child | 50% after deductible | |
| Mental/Behavioral Health Inpatient Services | 20% after deductible | |
| Mental/Behavioral Health Outpatient Services | 20% after deductible | Coverage for treatment of Mental Disorders does NOT include counseling services such as career counseling, marriage counseling, divorce counseling, parental counseling and job counseling.Education services and supplies including training or re-training for a |
| Non-Emergency Care When Traveling Outside the U.S. | 40% after deductible | |
| Non-Preferred Brand Drugs | 40% after deductible | Certain exclusion apply - Please see the contract book for a full list of pharmacy exclusions. |
| Nutritional Counseling | 20% after deductible | |
| Orthodontia - Adult | Not covered | |
| Orthodontia - Child | 50% after deductible | |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | 20% after deductible | |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 20% after deductible | |
| Outpatient Rehabilitation Services | 20% after deductible | Other exclusions include but not limited to:Visual therapy lifestyle/habit changing clinics and/or programs; recreational therapy; primarily to enhance athletic abilities; and/or inpatient pain rehabilitation and inpatient pain control programs |
| Outpatient Surgery Physician/Surgical Services | 20% after deductible | Exclusions include but not limited to:a. rhinoplasty;b. blepharoplasty services identified by CPT codes 15820, 15821, 15822, 15823; brow ptosis identified by CPT code 67900; or any revised or equivalent codes;c. gynecomastia;d. breast enlargement or |
| Preferred Brand Drugs | 40% after deductible | Certain exclusion apply - Please see the contract book for a full list of pharmacy exclusions. |
| Prenatal and Postnatal Care | 20% after deductible | |
| Prescription Drugs Other | 20% after deductible | |
| Preventive Care/Screening/Immunization | Free | Any services not included in the following Non-Grandfathered Preventive Care Services Brochure link is excluded: https://www.lablue.com/preventive |
| Primary Care Visit to Treat an Injury or Illness | 20% after deductible | |
| Private-Duty Nursing | 20% after deductible | |
| Prosthetic Devices | 20% after deductible | |
| Radiation | 20% after deductible | |
| Reconstructive Surgery | 20% after deductible | |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | 20% after deductible | |
| Rehabilitative Speech Therapy | 20% after deductible | |
| Routine Dental Services (Adult) | Not covered | |
| Routine Eye Exam (Adult) | Not covered | |
| Routine Eye Exam for Children | Free | 1 visit a year |
| Routine Foot Care | Not covered | |
| Skilled Nursing Facility | 20% after deductible | |
| Specialist Visit | 20% after deductible | |
| Specialty Drugs | 40% after deductible | Certain exclusion apply - Please see the contract book for a full list of pharmacy exclusions. |
| Substance Abuse Disorder Inpatient Services | 20% after deductible | |
| Substance Abuse Disorder Outpatient Services | 20% after deductible | |
| Transplant | 20% after deductible | Exclusions are but not limited to: any costs of donating an organ or tissue for transplant when a Member is a donor; the transplant of any non-human organ or tissue; or bone marrow transplants and stem cell rescue (autologous and allogeneic) are not covered |
| Treatment for Temporomandibular Joint Disorders | Not covered | |
| Urgent Care Centers or Facilities | 20% after deductible | |
| Weight Loss Programs | Not covered | |
| Well Baby Visits and Care | Free | |
| X-rays and Diagnostic Imaging | 20% after deductible |
How this plan works
POS: You pay less in the network. Some care outside it is covered at a higher cost, and specialists usually need a referral.
- Referral for specialists
- Not required
- Coinsurance
- 20% after the deductible
- Works with an HSA
- No
- Network
- Blue Connect HMO/POS (LAN006)
- Sold in
- 8 Louisiana countiesAcadia Parish, Evangeline Parish, Iberia Parish, Lafayette Parish, St. Landry Parish, St. Martin Parish, St. Mary Parish, Vermilion Parish
Summary of Benefits and Coverage (PDF) Plan brochure Covered drugs (formulary)
Other HMO Louisiana plans on the same network
The same doctors and hospitals, with different costs.
Questions about Blue Connect 80/60 $3400 with 2 $0 PCP Virtual Visits (L)
Does Blue Connect 80/60 $3400 with 2 $0 PCP Virtual Visits (L) cover my doctor?
Use "Find a doctor in this plan" on this page: choose the city, then the kind of doctor. The list shows providers HMO Louisiana lists in this plan's network for 2027. Directories can be out of date, so call the office to confirm before your visit.
What kind of plan is Blue Connect 80/60 $3400 with 2 $0 PCP Virtual Visits (L)?
It is a POS plan: you pay less in the network. Some care outside it is covered at a higher cost, and specialists usually need a referral. It is a Silver plan.
How much is a doctor visit with Blue Connect 80/60 $3400 with 2 $0 PCP Virtual Visits (L)?
A primary care visit costs 20% after deductible. A specialist visit costs 20% after deductible. These are in-network costs for one person. "After deductible" means you pay the full cost until you reach the $3,400 deductible.
Where is Blue Connect 80/60 $3400 with 2 $0 PCP Virtual Visits (L) sold?
It is sold to people who live in 8 Louisiana counties, through HealthCare.gov. The counties: Acadia Parish, Evangeline Parish, Iberia Parish, Lafayette Parish, St. Landry Parish, St. Martin Parish, St. Mary Parish, Vermilion Parish. HMO Louisiana's directory can also list providers outside these counties, such as pharmacies and specialists, but the plan itself is only for people who live in its area.
Why is there no monthly premium on this page?
Premiums depend on your age, county, household size and income, and most people get a subsidy, so a single price would mislead. HealthCare.gov shows the price for your household.
About this data
NPI Profile is not an insurance company, agent or broker, and it does not sell insurance or enroll anyone in a plan. It is a free reference tool built on public files that CMS and insurers publish, to help you compare Marketplace plans and check whether your current or future doctor is in a plan's network. It is not affiliated with CMS, HealthCare.gov, any state exchange or any insurer. Confirm costs and networks with the insurer and the doctor's office, and enroll on HealthCare.gov.
| Source | What it provides here | Source date |
|---|---|---|
| CMS Marketplace public use files (Plan Attributes, Benefits and Cost Sharing, Service Area) | This plan's costs, covered services, coverage examples and the counties where it is sold | Plan year 2027 |
| HMO Louisiana's provider directory | The doctors and facilities listed in this plan's network. Only providers with an address in Louisiana are counted. | Updated November 5, 2026 |
| NPPES NPI registry | Provider names, practice addresses and primary specialties | Matched November 8, 2026 |
- Costs are for the standard version of the plan, for one person, in network. People who qualify for cost-sharing reductions pay less.
- Monthly premiums are not shown: they depend on age, county, household and income. HealthCare.gov lists them for your household.
- Confirm costs in the plan documents and with the insurer, and confirm with the doctor's office that they take this plan.
