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my Blue Access WV EPO Gold 1000 - 2 Free PCP Visits
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my Blue Access WV EPO Gold 1000 - 2 Free PCP Visits

Overview
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my Blue Access WV EPO Gold 1000 - 2 Free PCP Visits is an individual health health plan issued by Highmark Blue Cross Blue Shield West Virginia 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 Nicholas county, West Virginia.

What Type of Health Plan Is This?

This plan is an EPO plan, which is also known as an "Exclusive Provider Organization." An EPO is a managed care plan where services are covered so long as the the hospitals, dentists, and other health providers in the plan's network are used.

Where Can I Buy This Plan?

You can purchase this plan at HealthCare.gov.

About
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Issuer
Highmark Blue Cross Blue Shield West Virginia
Plan ID
31274WV0500006
Coverage area
Nicholas County, West Virginia
Phone
Local Phone: 1-888-601-2109
Toll-Free: 1-888-601-2109
TTY: 1-888-601-2109
Plan type
EPO
Coverage type
Medical deductible
$1,000
Out-of-pocket maximum
$7,000
Generic drug co-pay
$5
Preferred brand drug co-pay
$30
Primary care physician visit cost
$20
Specialist doctor visit cost
$45
Doctor Visits
Primary Care Visit $20
Specialist Visit $45
Emergency Room Visit $500 Copay after deductible
Inpatient Facility Visit 20% Coinsurance after deductible
Inpatient Physician Visit 20% Coinsurance after deductible
Prescription Drugs
Generic Drugs $5
Preferred Brand Drugs $30
Non-preferred Brand Drugs 35%
Specialty Drugs 50%
Medical Deductible
Medical Deductible (Individual) $1,000
Medical Maximum Out Of Pocket (Individual) $7,000
Medical Deductible (Family) $2,000
Medical Maximum Out Of Pocket (Family) $14,000
Drug Deductible
Drug Deductible (Individual) $0
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) $0
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 100.00%
Premium Child Age 0-14 527
Premium Child Age 18 628
Premium Adult Individual Age 21 688
Premium Adult Individual Age 27 722
Premium Adult Individual Age 30 781
Premium Adult Individual Age 40 880
Premium Adult Individual Age 50 1,230
Premium Adult Individual Age 60 1,869
Premium Couple 21 1,377
Premium Couple 30 1,563
Premium Couple 40 1,760
Premium Couple 50 2,460
Premium Couple 60 3,739
Couple+1 child, Age 21 1,904
Couple+1 child, Age 30 2,090
Couple+1 child, Age 40 2,287
Couple+1 child, Age 50 2,987
Couple+2 children, Age 21 2,431
Couple+2 children, Age 30 2,617
Couple+2 children, Age 40 2,814
Couple+2 children, Age 50 3,514
Couple+3 or more Children, Age 21 2,958
Couple+3 or more Children, Age 30 3,144
Couple+3 or more Children, Age 40 3,341
Couple+3 or more Children, Age 50 4,041
Individual+1 child, Age 21 1,215
Individual+1 child, Age 30 1,308
Individual+1 child, Age 40 1,407
Individual+1 child, Age 50 1,757
Individual+2 children, Age 21 1,742
Individual+2 children, Age 30 1836
Individual+2 children, Age 40 1,934
Individual+2 children, Age 50 2,284
Individual+3 or more children, Age 21 2,270
Individual+3 or more children, Age 30 2,363
Individual+3 or more children, Age 40 2,461
Individual+3 or more children, Age 50 2,811
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