BlueEssentials Gold 5

Health Insurance Plan Details (2026 Plan)

EPO

Gold

Deductible (per individual)	$250 /yr
Deductible (per family)	$500 /yr
Max Out-of-Pocket (per individual)	$9,200 /yr
Max Out-of-Pocket (per family)	$18,400 /yr
Drug Deductible (per individual)	$1,000
Drug Deductible (per family)	$2000
Drug Max Out-of-Pocket (per individual)	Included in Medical
Drug Max Out-of-Pocket (per family)	Included in Medical
Plan Type	EPO
Includes Child Dental?	No
Includes Adult Dental?	No

Medical Services
Preventive Care	No Charge
Primary Care Visit	$20 Copay
Specialist Visit	$40 Copay
Emergency Room	50% Coinsurance after deductible
Inpatient Facility	50% Coinsurance after deductible
Inpatient Physician	50% Coinsurance after deductible

Drug Costs
Generic Drugs	$10 Copay
Preferred Brand Drugs	$40 Copay
Non-preferred Brand Drugs	50% Coinsurance after deductible
Specialty Drugs	50% Coinsurance after deductible

Summary of Benefits and Coverage	SBC doc
Provider Directory	Doctor lookup
Drug Formulary List	drug list

* 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

Obamacare Plans

Off-Exchange Plans

Get advice from Licensed Insurance Agents

Looking for Other Options?

Short Term Health Insurance Plans

Call for a free quote & benefits review

Find the right short term coverage for your needs.