Blue Plus Minnesota Value HSA Gold Plan 207

Health Insurance Plan Details (2026 Plan)

Monthly Premium

PPO
$ubsidy
HSA
Gold
Deductible
N/A /yr
Max Out-of-Pocket
N/A /yr

Details

Deductible (per individual)$3,400 /yr
Deductible (per family)$10,200 /yr
Max Out-of-Pocket (per individual)$5,600 /yr
Max Out-of-Pocket (per family)$16,800 /yr
Plan TypePPO
Includes Child Dental?No
Includes Adult Dental?No
Medical Services
Preventive CareNo Charge
Primary Care Visit5.00% Coinsurance after deductible
Specialist Visit5.00% Coinsurance after deductible
Emergency Room5.00% Coinsurance after deductible
Inpatient Facility5.00% Coinsurance after deductible
Inpatient Physician5.00% Coinsurance after deductible
Drug Costs
Generic Drugs5.00% Coinsurance after deductible
Preferred Brand Drugs5.00% Coinsurance after deductible
Non-preferred Brand Drugs20.00% Coinsurance after deductible
Specialty Drugs5.00% Coinsurance after deductible

Plan Documents

Summary of Benefits and CoverageSBC doc
Provider DirectoryDoctor lookup
Drug Formulary Listn/a

* Figures shown are only for in-network medical costs

** Please check with insurance company if Copay and Coinsurance rates are before or after the deductible


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