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BlueSelect Bronze Balance
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BlueSelect Bronze Balance

Overview
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BlueSelect Bronze Balance is an individual health health plan issued by Blue Cross Blue Shield of Wyoming and is available for the year 2019. This health plan is offered by the federal government through HealthCare.gov and the Affordable Care Act (ACA).

Where Do I Need to Live to Quality for this Plan?

This plan is available for qualifying individuals who live in Uinta county, Wyoming.

What Type of Health Plan Is This?

This plan is a PPO plan, which is also known as a "Preferred Provider Organization." In this type of insurance plan, you can choose to receive care from doctors, hospitals, and other providers who are in-network or out-of-network. You pay less if you use in-network providers. In a PPO plan, you can visit any doctor without getting a referral.

Where Can I Buy This Plan?

You can purchase this plan at HealthCare.gov.

About
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Issuer
Blue Cross Blue Shield of Wyoming
Plan ID
11269WY0070022
Coverage area
Uinta County, Wyoming
Phone
Local Phone: 1-307-634-1393x2949
Toll-Free: 1-800-851-2227
TTY: 1-800-696-4710
Plan type
PPO
Coverage type
Medical deductible
$7,900
Out-of-pocket maximum
$7,900
Generic drug co-pay
30% Coinsurance after deductible
Preferred brand drug co-pay
30% Coinsurance after deductible
Primary care physician visit cost
30% Coinsurance after deductible
Specialist doctor visit cost
30% Coinsurance after deductible
Doctor Visits
Primary Care Visit 30% Coinsurance after deductible
Specialist Visit 30% Coinsurance after deductible
Emergency Room Visit $1500 Copay with deductible and 50% Coinsurance after deductible
Inpatient Facility Visit 50% Coinsurance after deductible
Inpatient Physician Visit 30% Coinsurance after deductible
Prescription Drugs
Generic Drugs 30% Coinsurance after deductible
Preferred Brand Drugs 30% Coinsurance after deductible
Non-preferred Brand Drugs 30% Coinsurance after deductible
Specialty Drugs 30% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $7,900
Medical Maximum Out Of Pocket (Individual) $7,900
Medical Deductible (Family) $15,800
Medical Maximum Out Of Pocket (Family) $15,800
Drug Deductible
Drug Deductible (Individual) Included in Medical
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) Included in Medical
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 100.00%
Premium Child Age 0-14 370
Premium Child Age 18 441
Premium Adult Individual Age 21 483
Premium Adult Individual Age 27 506
Premium Adult Individual Age 30 548
Premium Adult Individual Age 40 618
Premium Adult Individual Age 50 863
Premium Adult Individual Age 60 1,312
Premium Couple 21 967
Premium Couple 30 1,097
Premium Couple 40 1,236
Premium Couple 50 1,727
Premium Couple 60 2,625
Couple+1 child, Age 21 1,337
Couple+1 child, Age 30 1,467
Couple+1 child, Age 40 1,606
Couple+1 child, Age 50 2,097
Couple+2 children, Age 21 1,707
Couple+2 children, Age 30 1838
Couple+2 children, Age 40 1,976
Couple+2 children, Age 50 2,467
Couple+3 or more Children, Age 21 2,077
Couple+3 or more Children, Age 30 2,208
Couple+3 or more Children, Age 40 2,346
Couple+3 or more Children, Age 50 2,837
Individual+1 child, Age 21 853
Individual+1 child, Age 30 919
Individual+1 child, Age 40 988
Individual+1 child, Age 50 1,233
Individual+2 children, Age 21 1,223
Individual+2 children, Age 30 1,289
Individual+2 children, Age 40 1,358
Individual+2 children, Age 50 1,603
Individual+3 or more children, Age 21 1,593
Individual+3 or more children, Age 30 1,659
Individual+3 or more children, Age 40 1,728
Individual+3 or more children, Age 50 1,973
Reference
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  • HealthCare.gov. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov
  • The 'metal' categories: Bronze, Silver, Gold & Platinum. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plans-categories
  • Health insurance plan & network types: HMOs, PPOs, and more. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plan-types