Plan options for 2021
Platinum
This is a top-level plan with a $0 deductible. The copays listed are not a complete list of services that require a copay.
Monthly premium
High
Deductible
$0
Out-of-pocket maximum
$4,000
PCP office visit copay
$15
Individual annual deductible
Individual annual deductible
An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay.
In network
$0
Out of network
Not covered
Family annual deductible
Family annual deductible
A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay.
In network
$0
Out of network
Not covered
Coinsurance percentage
Coinsurance percentage
Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.
In network
0%
Out of network
Not covered
Embedded coinsurance maximum
Embedded coinsurance maximum
The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.
In network
N/A
Out of network
Not covered
Individual out-of-pocket maximum
Out-of-pocket maximum
This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.
In network
$4,000
Out of network
Not covered
Family out-of-pocket maximum
Out-of-pocket maximum
This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.
In network
$8,000
Out of network
Not covered
PCP office visit copay
PCP office visit copay
This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.
In network
$15
Out of network
Not covered
Specialist care copay (when referred)
In network
$40
Out of network
Not covered
Retail health clinic copay
In network
$40
Out of network
Not covered
Urgent care copay
In network
$40
Out of network
Not covered
Emergency room copay
In network
$250
Out of network
Not covered
Ambulance copay (when medically necessary)
In network
$100
Out of network
Not covered
Preferred generic pharmacy copay
Preferred generic pharmacy copay
This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.
In network
$4
Out of network
Not covered
|
|
|
||
|---|---|---|---|
|
Individual annual deductible An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. |
$0 | Not covered | |
|
Family annual deductible A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. |
$0 | Not covered | |
|
Coinsurance percentage Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible. |
0% | Not covered | |
|
Embedded coinsurance maximum The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum. |
N/A | Not covered | |
|
Out-of-pocket maximum This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services. |
$4,000 | Not covered | |
|
Out-of-pocket maximum This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services. |
$8,000 | Not covered | |
|
PCP office visit copay This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care. |
$15 | Not covered | |
|
|
$40 | Not covered | |
|
|
$40 | Not covered | |
|
|
$40 | Not covered | |
|
|
$250 | Not covered | |
|
|
$100 | Not covered | |
|
Preferred generic pharmacy copay This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs. |
$4 | Not covered |
Gold
This is a mid-level plan with a $0 deductible. The copays listed are not a complete list of services that require a copay.
Monthly premium
Medium
Deductible
$0
Out-of-pocket maximum
$6,500
PCP office visit copay
$20
Individual annual deductible
Individual annual deductible
An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay.
In network
$0
Out of network
Not covered
Family annual deductible
Family annual deductible
A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay.
In network
$0
Out of network
Not covered
Coinsurance percentage
Coinsurance percentage
Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible.
In network
0%
Out of network
Not covered
Embedded coinsurance maximum
Embedded coinsurance maximum
The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum.
In network
N/A
Out of network
Not covered
Individual out-of-pocket maximum
Out-of-pocket maximum
This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.
In network
$6,500
Out of network
Not covered
Family out-of-pocket maximum
Out-of-pocket maximum
This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services.
In network
$13,000
Out of network
Not covered
PCP office visit copay
PCP office visit copay
This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care.
In network
$20
Out of network
Not covered
Specialist care copay (when referred)
In network
$50
Out of network
Not covered
Retail health clinic copay
In network
$50
Out of network
Not covered
Urgent care copay
In network
$50
Out of network
Not covered
Emergency room copay
In network
$250
Out of network
Not covered
Ambulance copay (when medically necessary)
In network
$100
Out of network
Not covered
Preferred generic pharmacy copay
Preferred generic pharmacy copay
This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs.
In network
$10
Out of network
Not covered
|
|
|
||
|---|---|---|---|
|
Individual annual deductible An individual annual deductible is the amount you pay each year for health services before your health insurance begins to pay. |
$0 | Not covered | |
|
Family annual deductible A family annual deductible is the amount you and others on your plan have to pay each year for health services before your health insurance begins to pay. |
$0 | Not covered | |
|
Coinsurance percentage Coinsurance is your share of the cost of a health care service. It’s usually figured as a percentage of the total charge for the service. You start paying coinsurance once you’ve met your plan’s deductible. |
0% | Not covered | |
|
Embedded coinsurance maximum The embedded coinsurance maximum is the most you’ll have to pay in coinsurance during a policy period. It makes up part of the out-of-pocket maximum. |
N/A | Not covered | |
|
Out-of-pocket maximum This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services. |
$6,500 | Not covered | |
|
Out-of-pocket maximum This represents the most you’ll have to pay during a policy period, usually a year, for health care services. Once you've reached it, your plan pays 100% of the allowed amount for covered services. |
$13,000 | Not covered | |
|
PCP office visit copay This is what you'll pay when you see your primary care physician, the doctor you've selected to oversee your health care. |
$20 | Not covered | |
|
|
$50 | Not covered | |
|
|
$50 | Not covered | |
|
|
$50 | Not covered | |
|
|
$250 | Not covered | |
|
|
$100 | Not covered | |
|
Preferred generic pharmacy copay This is what you'll pay when you buy a commonly prescribed generic version of a brand-name drug. This is the lowest copay tier for prescription drugs. |
$10 | Not covered |
See how Smarter, Better Healthcare℠ tackles your small business challenges
Access to care
Choices for careHelping your employees avoid costly ER visits and get the care they need quickly and conveniently.
Value-based careElevating the quality of care by rewarding physicians for better patient health outcomes.
Improved care
Blue Cross Coordinated Care CoreA care management program for your employees and their family members who face complex health issues.
Health & Well-BeingEncourage a culture of well-being with tools and resources to help your employees improve their whole health.
Plan understanding
Online member accountYour employees will get the tools, information and support they need all under one secure online account.
Blue Cross RewardsIncentivizing employees with PPO plans to use cost-effective providers by using our Find Care tools.
Explore health care insights
Read about the latest news and innovations from the experts themselves.
See all insights
Blue Cross Masterclass
Join a live presentation with our health care experts, examining topics you've told us mean the most to your business.
Reserve your seat
What you need to know about the coronavirus
Read the latest updates on how officials and are responding to the global pandemic.
Read more
Resources to share with your employees
Browse brochures, videos and posters designed to help your employees get the most out of their Blue Cross coverage.
View toolkitsMore plans you may be interested in
Simply Blue℠ PPO
This classic PPO plan has the largest network of doctors and all the essential health benefits you expect.
Blue Elect Plus℠ POS
Our point of service plan offers affordability and the freedom to choose a doctor or specialist without a referral.
BCN HMO℠
This streamlined and affordable plan has just one point of contact for your employees, their primary care physician.