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BlueSelect Bronze Core
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BlueSelect Bronze Core

Overview
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BlueSelect Bronze Core 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 Weston 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
11269WY0070004
Coverage area
Weston 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
$4,500
Out-of-pocket maximum
$6,750
Generic drug co-pay
50% Coinsurance after deductible
Preferred brand drug co-pay
50% Coinsurance after deductible
Primary care physician visit cost
50% Coinsurance after deductible
Specialist doctor visit cost
50% Coinsurance after deductible
Doctor Visits
Primary Care Visit 50% Coinsurance after deductible
Specialist Visit 50% Coinsurance after deductible
Emergency Room Visit 50% Coinsurance after deductible
Inpatient Facility Visit 50% Coinsurance after deductible
Inpatient Physician Visit 50% Coinsurance after deductible
Prescription Drugs
Generic Drugs 50% Coinsurance after deductible
Preferred Brand Drugs 50% Coinsurance after deductible
Non-preferred Brand Drugs 50% Coinsurance after deductible
Specialty Drugs 50% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $4,500
Medical Maximum Out Of Pocket (Individual) $6,750
Medical Deductible (Family) $9,000
Medical Maximum Out Of Pocket (Family) $13,500
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 0-14 348
Premium Child Age 18 416
Premium Adult Individual Age 21 455
Premium Adult Individual Age 27 477
Premium Adult Individual Age 30 517
Premium Adult Individual Age 40 582
Premium Adult Individual Age 50 814
Premium Adult Individual Age 60 1,237
Premium Couple 21 911
Premium Couple 30 1,034
Premium Couple 40 1,165
Premium Couple 50 1,628
Premium Couple 60 2,474
Couple+1 child, Age 21 1,260
Couple+1 child, Age 30 1,383
Couple+1 child, Age 40 1,513
Couple+1 child, Age 50 1,977
Couple+2 children, Age 21 1,609
Couple+2 children, Age 30 1,732
Couple+2 children, Age 40 1,862
Couple+2 children, Age 50 2,325
Couple+3 or more Children, Age 21 1,958
Couple+3 or more Children, Age 30 2,081
Couple+3 or more Children, Age 40 2,211
Couple+3 or more Children, Age 50 2,674
Individual+1 child, Age 21 804
Individual+1 child, Age 30 866
Individual+1 child, Age 40 931
Individual+1 child, Age 50 1,162
Individual+2 children, Age 21 1,153
Individual+2 children, Age 30 1,214
Individual+2 children, Age 40 1,280
Individual+2 children, Age 50 1,511
Individual+3 or more children, Age 21 1,502
Individual+3 or more children, Age 30 1,563
Individual+3 or more children, Age 40 1,628
Individual+3 or more children, Age 50 1,860
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