Blue Plus Easy Compare Gold and Rx Copay Blue Plus Minnesota Value Plan 205

Health Insurance Plan Details (2026 Plan)

Monthly Premium

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

Details

Deductible (per individual)$2,000 /yr
Deductible (per family)$4,000 /yr
Max Out-of-Pocket (per individual)$8,200 /yr
Max Out-of-Pocket (per family)$16,400 /yr
Plan TypePPO
Includes Child Dental?No
Includes Adult Dental?No
Medical Services
Preventive CareNo Charge
Primary Care Visit$30 Copay
Specialist Visit$70 Copay
Emergency Room20.00% Coinsurance after deductible
Inpatient Facility20.00% Coinsurance after deductible
Inpatient Physician20.00% Coinsurance after deductible
Drug Costs
Generic Drugs$15 Copay
Preferred Brand Drugs$30 Copay
Non-preferred Brand Drugs$90 Copay
Specialty Drugs$360 Copay

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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