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my Blue Access WV EPO Silver 4450 HSA
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my Blue Access WV EPO Silver 4450 HSA

Overview
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my Blue Access WV EPO Silver 4450 HSA 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 Marshall 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
31274WV0510001
Coverage area
Marshall 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
$4,450
Out-of-pocket maximum
$6,650
Generic drug co-pay
10% Coinsurance after deductible
Preferred brand drug co-pay
10% Coinsurance after deductible
Primary care physician visit cost
10% Coinsurance after deductible
Specialist doctor visit cost
10% Coinsurance after deductible
Doctor Visits
Primary Care Visit 10% Coinsurance after deductible
Specialist Visit 10% Coinsurance after deductible
Emergency Room Visit 10% Coinsurance after deductible
Inpatient Facility Visit 10% Coinsurance after deductible
Inpatient Physician Visit 10% Coinsurance after deductible
Prescription Drugs
Generic Drugs 10% Coinsurance after deductible
Preferred Brand Drugs 10% Coinsurance after deductible
Non-preferred Brand Drugs 10% Coinsurance after deductible
Specialty Drugs 10% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $4,450
Medical Maximum Out Of Pocket (Individual) $6,650
Medical Deductible (Family) $8,900
Medical Maximum Out Of Pocket (Family) $13,300
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 0-14 366
Premium Child Age 18 437
Premium Adult Individual Age 21 479
Premium Adult Individual Age 27 502
Premium Adult Individual Age 30 544
Premium Adult Individual Age 40 613
Premium Adult Individual Age 50 856
Premium Adult Individual Age 60 1,301
Premium Couple 21 959
Premium Couple 30 1,088
Premium Couple 40 1,226
Premium Couple 50 1,713
Premium Couple 60 2,603
Couple+1 child, Age 21 1,326
Couple+1 child, Age 30 1,455
Couple+1 child, Age 40 1,593
Couple+1 child, Age 50 2,080
Couple+2 children, Age 21 1,693
Couple+2 children, Age 30 1,822
Couple+2 children, Age 40 1,960
Couple+2 children, Age 50 2,447
Couple+3 or more Children, Age 21 2,060
Couple+3 or more Children, Age 30 2,189
Couple+3 or more Children, Age 40 2,327
Couple+3 or more Children, Age 50 2,814
Individual+1 child, Age 21 846
Individual+1 child, Age 30 911
Individual+1 child, Age 40 980
Individual+1 child, Age 50 1,223
Individual+2 children, Age 21 1,213
Individual+2 children, Age 30 1,278
Individual+2 children, Age 40 1,347
Individual+2 children, Age 50 1,590
Individual+3 or more children, Age 21 1,580
Individual+3 or more children, Age 30 1,645
Individual+3 or more children, Age 40 1,714
Individual+3 or more children, Age 50 1,957
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