PPO Medical Plan

The PPO Medical Plan covers in-network preventive care, office visits and hospital emergency room care with no deductible; you pay only a flat-dollar copay for these services—and you pay nothing for in-network preventive care. For most other in-network services, you pay 20% after meeting your annual deductible.

In-Network vs. Out-of-Network Care

In-network providers have negotiated service rates with Credence BCBS. An out-of-network provider may charge more than Credence BCBS is willing to pay. Because of this, the out-of-network deductible is higher than the in-network deductible. Before receiving treatment, check with Credence BCBS to ensure a doctor, lab, hospital, specialist or other provider is in-network, how much care will cost and to understand your health plan.

Plan Feature In-Network Out-Of-Network

Annual Deductible (embedded)1

Individual: $750 Family: $1,500

Individual: $1,500 Family: $3,000

Annual Out-of-Pocket Maximum (embedded)1

Individual: $4,250 Family: $8,500

Individual: $8,500 Family: $17,000

Preventive Care2

You pay nothing for plan-eligible preventive care; no deductible applies

You pay 40%, after deductible


You pay 20%, after deductible

You pay 40%, after deductible

Office Visit Copay

Primary Care Physician: $30

Specialist: $60

You pay 40%, after deductible

Hospital Emergency Room Care

Plan pays 100% after you pay $150 copay

If claim is submitted with a non-emergency diagnosis, an additional $200 will apply

Plan pays 100% after you pay $150 copay

If claim is submitted with a non-emergency diagnosis, you pay 40% after deductible 

  1. “Embedded” means if any one individual reaches the individual threshold, that individual progresses to the coinsurance or 100% benefit level regardless of coverage tier.
  2. For specific preventive services, a list of covered immunizations, visit limitations and/or pre-certification requirements, refer to the Summary Plan Descriptions at TennecoPlanDocs.com or visit credenceblue.com.

If you’re enrolled, you and your eligible dependents also have 24/7 access to board-certified physicians from the comfort of your home, office or wherever you are through Teladoc.


The HSA Medical Plan and PPO Medical Plan offer (in certain geographical areas) high-performance provider Blue Select Networks with high-quality, cost-efficient care. While most current providers participate in the Blue Select Network, provider affiliations vary and are subject to change. Credence BCBS will notify you directly and issue a new medical ID Card if your geographic location becomes part of the Blue Select Network. It is always recommended to check if your provider is in network, which can easily be done via credenceblue.com or 877-733-4375.

Have You Visited Credence Well-being?

By visiting credenceblue.com you have access to Credence Well-being where you can find in-network providers, get cost estimates and discover how your health plan works by using the Find Care tool. For additional help navigating your healthcare needs, click Get Help and speak directly to a Care Guide. Care Guides provide personalized support to help you make the most of your benefits.