Premera Blue Cross Preferred Gold
Premera Blue Cross · 2027 plan year
Gold
- Ind. deductible
- $1,500
- Family deductible
- $3,000
- Ind. OOP max
- $7,000
- Family OOP max
- $14,000
Compare with other Gold plans in WA
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More Premera Blue Cross plans in WA
Monthly premiums by age
Rating Area 4 — the lowest-priced of the 8 areas this plan covers. Premiums differ by area.
| Age | Individual |
|---|---|
| Under 15 | $675 |
| 21 | $882 |
| 30 | $1,001 |
| 40 | $1,127 |
| 50 | $1,575 |
| 60 | $2,394 |
| 64 and over | $2,646 |
Live premium estimate
Benefits & cost sharing
Primary Care
| Benefit | In-network |
|---|---|
| Preventive Care/Screening/Immunization | No charge |
| Primary Care Visit to Treat an Injury or Illness | $15.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $45.00 |
Hospital
| Benefit | In-network |
|---|---|
| Urgent Care Centers or Facilities | $45.00 |
| Emergency Room Services | 30.00% Coinsurance after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | 30.00% Coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | 30.00% Coinsurance after deductible |
Pharmacy
| Benefit | In-network |
|---|---|
| Specialty Drugs | 50.00% Coinsurance after deductible |
| Generic Drugs | $10.00 |
| Non-Preferred Brand Drugs | 45.00% Coinsurance after deductible |
| Preferred Brand Drugs | 30.00% Coinsurance after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 30.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | $45.00 |
Other
| Benefit | In-network |
|---|---|
| Skilled Nursing Facility | 30.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | 30.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | $45.00 |
| Transplant | 30.00% Coinsurance after deductible |
| Treatment for Temporomandibular Joint Disorders | 30.00% Coinsurance after deductible |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | 30.00% Coinsurance after deductible |
| Abortion for Which Public Funding is Prohibited | No charge |
| Acupuncture | $45.00 |
| Chemotherapy | 30.00% Coinsurance after deductible |
| Chiropractic Care | $45.00 |
| Cosmetic Surgery | 30.00% Coinsurance after deductible |
| Routine Eye Exam for Children | $30.00 |
| Routine Foot Care | $15.00 |
| Delivery and All Inpatient Services for Maternity Care | 30.00% Coinsurance after deductible |
| Dental Anesthesia | 30.00% Coinsurance after deductible |
| Diabetes Care Management | No charge |
| Diabetes Education | No charge |
| Dialysis | 30.00% Coinsurance after deductible |
| Durable Medical Equipment | 30.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | 30.00% Coinsurance after deductible |
| Eye Glasses for Children | No charge |
| Gender Affirming Care | 30.00% Coinsurance after deductible |
| Habilitation Services | $45.00 |
| Hearing Aids | 30.00% |
| Hearing Exams | $45.00 |
| Home Health Care Services | 30.00% Coinsurance after deductible |
| Hospice Services | 30.00% Coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs) | 30.00% Coinsurance after deductible |
| Infertility Treatment | 30.00% Coinsurance after deductible |
| Infusion Therapy | 30.00% Coinsurance after deductible |
| Inherited Metabolic Disorder - PKU | 30.00% Coinsurance after deductible |
| Inpatient Physician and Surgical Services | 30.00% Coinsurance after deductible |
| Laboratory Outpatient and Professional Services | 30.00% Coinsurance after deductible |
| Long-Term/Custodial Nursing Home Care | 30.00% Coinsurance after deductible |
| Nutritional Counseling | No charge |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $15.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 30.00% Coinsurance after deductible |
| Outpatient Rehabilitation Services | $45.00 |
| Prenatal and Postnatal Care | No charge |
| Prosthetic Devices | 30.00% Coinsurance after deductible |
| Radiation | 30.00% Coinsurance after deductible |
| Reconstructive Surgery | 30.00% Coinsurance after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $45.00 |
| Rehabilitative Speech Therapy | $45.00 |
Service area
This plan covers 24 geographic areas.
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