Sold outside the marketplace. This plan is bought directly from the insurer, so it is not eligible for a premium tax credit. If your income qualifies you for savings, a marketplace plan at the same price will usually cost you less.

Blue Advantage Plus Gold℠ 803

Blue Cross and Blue Shield of Texas · 2026 plan year

Gold
Ind. deductible
$2,400
Family deductible
$4,800
Ind. OOP max
$10,400
Family OOP max
$20,800

More Blue Cross and Blue Shield of Texas plans in TX

Monthly premiums by age

Rating Area 11

AgeIndividualIndividual + tobacco
Under 15$455$455
21$595$595
30$675$766
40$760$980
50$1,062$1,405
60$1,614$2,074
64 and over$1,784$2,292

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or IllnessNo charge

Specialist

BenefitIn-network
Specialist Visit$35.00

Hospital

BenefitIn-network
Emergency Room Services$1000.00 Copay with deductible + 30.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)$950.00 Copay per Stay with deductible + 30.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services30.00% Coinsurance after deductible
Urgent Care Centers or Facilities$20.00

Pharmacy

BenefitIn-network
Generic DrugsNo charge
Non-Preferred Brand Drugs35.00% Coinsurance after deductible
Preferred Brand Drugs$50.00
Specialty Drugs45.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services$950.00 Copay per Stay with deductible + 30.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient ServicesNo charge

Other

BenefitIn-network
Durable Medical Equipment30.00% Coinsurance after deductible
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental30.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing30.00% Coinsurance after deductible
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Chemotherapy30.00% Coinsurance after deductible
Chiropractic Care30.00% Coinsurance after deductible
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care$950.00 Copay with deductible + 30.00% Coinsurance after deductible
Dental Check-Up for ChildrenNot covered
Diabetes Education30.00% Coinsurance after deductible
Dialysis30.00% Coinsurance after deductible
Emergency Transportation/Ambulance30.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Habilitation Services30.00% Coinsurance after deductible
Hearing Aids30.00% Coinsurance after deductible
Home Health Care Services30.00% Coinsurance after deductible
Hospice Services30.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)20.00% Coinsurance after deductible
Infertility TreatmentNot covered
Infusion Therapy$100.00
Inpatient Physician and Surgical Services30.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services20.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutritional CounselingNot covered
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$35.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)20.00% Coinsurance after deductible
Outpatient Rehabilitation Services30.00% Coinsurance after deductible
Prenatal and Postnatal CareNo charge
Private-Duty NursingNot covered
Prosthetic Devices30.00% Coinsurance after deductible
Radiation30.00% Coinsurance after deductible
Reconstructive Surgery30.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy30.00% Coinsurance after deductible
Rehabilitative Speech Therapy30.00% Coinsurance after deductible
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility30.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services$950.00 Copay per Stay with deductible + 30.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient ServicesNo charge
Transplant30.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders30.00% Coinsurance after deductible
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging20.00% Coinsurance after deductible

Service area

This plan covers 6 geographic areas.

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