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my Blue Access WV EPO Silver 0
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my Blue Access WV EPO Silver 0

Overview
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my Blue Access WV EPO Silver 0 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 Upshur 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
31274WV0500004
Coverage area
Upshur 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
$0
Out-of-pocket maximum
$7,800
Generic drug co-pay
$5
Preferred brand drug co-pay
$30
Primary care physician visit cost
$40
Specialist doctor visit cost
$90
Doctor Visits
Primary Care Visit $40
Specialist Visit $90
Emergency Room Visit $1,400
Inpatient Facility Visit $3900 Copay per Day
Inpatient Physician Visit 40% 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) $0
Medical Maximum Out Of Pocket (Individual) $7,800
Medical Deductible (Family) $0
Medical Maximum Out Of Pocket (Family) $15,600
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 0-14 424
Premium Child Age 18 506
Premium Adult Individual Age 21 555
Premium Adult Individual Age 27 581
Premium Adult Individual Age 30 630
Premium Adult Individual Age 40 709
Premium Adult Individual Age 50 991
Premium Adult Individual Age 60 1,506
Premium Couple 21 1,110
Premium Couple 30 1,260
Premium Couple 40 1,419
Premium Couple 50 1,983
Premium Couple 60 3,013
Couple+1 child, Age 21 1,535
Couple+1 child, Age 30 1,685
Couple+1 child, Age 40 1,843
Couple+1 child, Age 50 2,407
Couple+2 children, Age 21 1,959
Couple+2 children, Age 30 2,109
Couple+2 children, Age 40 2,268
Couple+2 children, Age 50 2,832
Couple+3 or more Children, Age 21 2,384
Couple+3 or more Children, Age 30 2,534
Couple+3 or more Children, Age 40 2,693
Couple+3 or more Children, Age 50 3,257
Individual+1 child, Age 21 979
Individual+1 child, Age 30 1,054
Individual+1 child, Age 40 1,134
Individual+1 child, Age 50 1,416
Individual+2 children, Age 21 1,404
Individual+2 children, Age 30 1,479
Individual+2 children, Age 40 1,559
Individual+2 children, Age 50 1,841
Individual+3 or more children, Age 21 1,829
Individual+3 or more children, Age 30 1,904
Individual+3 or more children, Age 40 1,983
Individual+3 or more children, Age 50 2,265
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