Balance Plans

Best value and budget-friendly

Overview

  • Encourages the use of lower cost options for medical care when possible.
  • Save money by choosing the most cost effective location for medical care.
    • Lower out-of-pocket expenses for medical services in Urgent Care, Surgery Centers or Doctors’ Offices.
    • Higher out-of-pocket expenses for medical services in Hospital,
      In-Patient and Out-Patient, or Emergency Rooms.
  • Promotes discussion with providers about available care options.

Good option if...

you are cost conscious and looking for the best value for your premium dollars.
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At-A-Glance

Gold Plan Silver Plan Bronze Plan
Professional
Services
Hospital
Services
Professional
Services
Hospital
Services
Professional
Services
Hospital
Services
HSA Eligible Learn More No No No
Participant deductible $500 $1,500 $1,500 $4,500 $3,500 $7,000
Family deductible $1,000 $3,000 $3,000 $9,000 $7,000 $14,000
Participant out-of-pocket $7,900 $7,900 $7,900
Family out-of-pocket $15,800 $15,800 $15,800
Coinsurance
BCBSWY Pays 80% 60% 75% 55% 70% 50%
Participant Pays 20% 40% 25% 45% 30% 50%
Preventive Care Paid at 100% of maximum allowable amount at appropriate intervals.
Primary Care
Copay $30 N/A $40 N/A Subject to the deductible & coinsurance N/A
Prescription Drugs
Tier 1: Generic Drugs Tier 2: Preferred Brand drugs $5 copay $50 copay $5 copay $100 copay Subject to the professional services deductible & coinsurance
Summary of Benefits and Coverage (SBC) View SBC View SBC View SBC

At-a-Glance is intended to be a condensed overview of some plan benefits and does not cover all benefits or information contained in the Benefit Booklet.  Limitations and exclusions do exist.  At-a-Glance is not a contract.  For exact benefits and limitations, please request a copy of the Benefit Booklet.

Cost Assistance

Based on certain income requirements, you may qualify for assistance, through government subsidies, with your monthly premiums. 

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