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 Gold PlanSilver PlanBronze Plan
 Professional
Services
Hospital
Services
Professional
Services
Hospital
Services
Professional
Services
Hospital
Services

HSA Eligible

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NoNoNo
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 Pays80%60%75%55%70%50%
Participant Pays20%40%25%45%30%50%
Preventive CarePaid at 100% of maximum allowable amount at appropriate intervals.
Primary Care
Copay$30N/A$40N/ASubject to the deductible & coinsuranceN/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
Gold Plan Silver Plan
HSA Eligible

Learn More

No No
Participant deductible $1,000 $4,000
Family deductible $2,000 $8,000
Participant out-of-pocket $7,900 $7,900
Family out-of-pocket $15,800 $15,800
Coinsurance

BCBSWY Pays

Participant Pays

80%

20%

75%

25%

Preventive Care Paid at 100% of maximum allowable amount at appropriate intervals.
Primary Care

Copay

$30 $45
Prescription Drugs

Tier 1: Generic Drugs

Tier 2: Preferred Brand drugs

$5/$0 copay

$20/$10 copay

$5/$0 copay

$50/$25 copay

Summary of Benefits and Coverage (SBC) View SBC  View SBC 
Bronze Plan
HSA Eligible

Learn More

No
Participant deductible $8,550
Family deductible $17,100
Participant out-of-pocket $8,550
Family out-of-pocket $17,100
Coinsurance

BCBSWY Pays

Participant Pays

100%

0%

Preventive Care Paid at 100% of maximum allowable amount at appropriate intervals.
Primary Care

Copay

Subject to the deductible & coinsurance

Prescription Drugs
Tier 1: Generic Drugs
Tier 2: Preferred Brand drugs
 

Subject to the deductible & coinsurance

Subject to the deductible & coinsurance

Summary of Benefits and Coverage (SBC) View SBC »

Cost Assistance

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


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Silver Plan Bronze Plan
HSA Eligible

Learn More

No No
Participant deductible $3,500 $6,000
Family deductible $7,000 $12,000
Participant out-of-pocket $7,900 $7,900
Family out-of-pocket $15,800 $15,800
Coinsurance

BCBSWY Pays

Participant Pays

80%

20%

80%

20%

Preventive Care Paid at 100% of maximum allowable amount at appropriate intervals.
Primary Care

Copay

$40 Subject to the deductible & coinsurance

Prescription Drugs
Tier 1: Generic DrugsTier 2: Preferred Brand drugs
$5 copay

$50 copay

$10 copay

$150 copay

Summary of Benefits and Coverage (SBC) View SBC »
View SBC »
Gold Plan Silver Plan
HSA Eligible

Learn More

No No
Participant deductible $750 $2,500
Family deductible $1,500 $5,000
Participant out-of-pocket $7,900 $7,900
Family out-of-pocket $15,800 $15,800
Coinsurance

BCBSWY Pays

Participant Pays

75%

25%

60%

40%

Preventive Care Paid at 100% of maximum allowable amount at appropriate intervals.
Primary Care

Copay
$30 $45
Prescription Drugs
Tier 1: Generic Drugs  $5 copay $5 copay
 Tier 2: Preferred Brand drugs $20 copay $50 copay
Summary of Benefits and Coverage (SBC)
View SBC

View SBC
Bronze Plan
Single Plan Family Plan
HSA Eligible

Learn More

Yes Yes
Participant deductible $4,500 NA
Family deductible NA $9,000
Participant out-of-pocket $6,750 $6,750
Family out-of-pocket NA $13,500
Coinsurance

BCBSWY Pays

Participant Pays

50%

50%

50%

50%

Preventive Care Paid at 100% of maximum allowable amount at appropriate intervals.
Primary Care

Copay

Subject to the deductible

& coinsurance

Subject to the deductible

& coinsurance

Prescription Drugs

Tier 1: Generic Drugs

Tier 2: Preferred Brand drugs

Subject to the deductible

& coinsurance

Subject to the deductible

& coinsurance

Summary of Benefits and Coverage (SBC) View SBC » View SBC »

We Make Adulting Easy

Whatever your needs, whatever your budget, Blue Cross Blue Shield of Wyoming has coverage plans to fit your needs.

WE Make Adulting Easy

If you’re turning 26 and currently on your parents’ health insurance, you have a few options to consider for obtaining your plan.

  • If you are currently employed, check with your Human Resources or Benefits Manager to see what health insurance options they offer.
  • If your employer doesn’t offer health insurance benefits, you are self-employed, or unemployed view the various plan options available to fit your budget and coverage needs.

Not sure which plan to choose? We’re here to help! Call us today at 1-800-851-2227, and one of our experts will help you through the process and find the right plan for you.

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