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BlueSelect Silver Classic
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BlueSelect Silver Classic

Overview
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BlueSelect Silver Classic 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 Teton 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
11269WY0070014
Coverage area
Teton 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
$2,500
Out-of-pocket maximum
$7,900
Generic drug co-pay
$5
Preferred brand drug co-pay
$50
Primary care physician visit cost
$45 and 40% Coinsurance after deductible
Specialist doctor visit cost
40% Coinsurance after deductible
Doctor Visits
Primary Care Visit $45 and 40% Coinsurance after deductible
Specialist Visit 40% Coinsurance after deductible
Emergency Room Visit 40% Coinsurance after deductible
Inpatient Facility Visit 40% Coinsurance after deductible
Inpatient Physician Visit 40% Coinsurance after deductible
Prescription Drugs
Generic Drugs $5
Preferred Brand Drugs $50
Non-preferred Brand Drugs 40% Coinsurance after deductible
Specialty Drugs 40% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $2,500
Medical Maximum Out Of Pocket (Individual) $7,900
Medical Deductible (Family) $5,000
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 0-14 522
Premium Child Age 18 623
Premium Adult Individual Age 21 683
Premium Adult Individual Age 27 716
Premium Adult Individual Age 30 775
Premium Adult Individual Age 40 873
Premium Adult Individual Age 50 1,220
Premium Adult Individual Age 60 1,854
Premium Couple 21 1,366
Premium Couple 30 1,551
Premium Couple 40 1,746
Premium Couple 50 2,441
Premium Couple 60 3,709
Couple+1 child, Age 21 1,889
Couple+1 child, Age 30 2,074
Couple+1 child, Age 40 2,269
Couple+1 child, Age 50 2,964
Couple+2 children, Age 21 2,412
Couple+2 children, Age 30 2,597
Couple+2 children, Age 40 2,792
Couple+2 children, Age 50 3,486
Couple+3 or more Children, Age 21 2,935
Couple+3 or more Children, Age 30 3,119
Couple+3 or more Children, Age 40 3,315
Couple+3 or more Children, Age 50 4,009
Individual+1 child, Age 21 1,206
Individual+1 child, Age 30 1,298
Individual+1 child, Age 40 1,396
Individual+1 child, Age 50 1,743
Individual+2 children, Age 21 1,729
Individual+2 children, Age 30 1,821
Individual+2 children, Age 40 1,919
Individual+2 children, Age 50 2,266
Individual+3 or more children, Age 21 2,251
Individual+3 or more children, Age 30 2,344
Individual+3 or more children, Age 40 2,441
Individual+3 or more children, Age 50 2,789
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