Standard Plans – 2024

Key coverage you can count on.

Ready for Blue?

Find the plan that’s right for you. Get a quote and enroll online.

Overview

  • Flexible copay options.
  • Premiums are typically lower.
  • Higher deductible plans.
  • Does not include kids dental options.
  • No cost for preventative services.

Good option if...

You’d like a straightforward plan to cover large medical expenses.

At-A-Glance

Gold Plan Silver Plan
HSA Eligible

Learn More

No No
Participant deductible $1,500 $5,900
Family deductible $3,000 $11,800
Participant out-of-pocket $8,700 $9,100
Family out-of-pocket $17,400 $18,200
Coinsurance

BCBSWY Pays

Participant Pays

 

75%

25%

 

60%

40%

Preventive Care Paid at 100% of maximum allowable amount at appropriate intervals when services are rendered by a network provider.
Primary Care

Copay
 

$30

 

$40

Prescription Drugs
Tier 1: Generic Drugs $15 copay $20 copay
 Tier 2: Preferred Brand drugs $30 copay $40 copay
Summary of Benefits and Coverage (SBC) View SBC
View SBC

*This plan does not include kid’s dental coverage.

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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Rx Tools

Find important information on your prescriptions, including how to select a pharmacy, request prescription benefits, and more.

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