my Blue Access WV PPO Gold 1700 HSA
Highmark Blue Cross Blue Shield West Virginia · 2026 plan year
GoldHSA eligible
- Ind. deductible
- $1,700
- Family deductible
- $3,400
- Ind. OOP max
- $7,100
- Family OOP max
- $14,200
Compare with other Gold plans in WV
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More Highmark Blue Cross Blue Shield West Virginia plans in WV
Monthly premiums by age
Rating Area 6 — the lowest-priced of the 11 areas this plan covers. Premiums differ by area.
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $530 | $530 |
| 21 | $692 | $710 |
| 30 | $786 | $805 |
| 40 | $885 | $973 |
| 50 | $1,236 | $1,515 |
| 60 | $1,879 | $2,302 |
| 64 and over | $2,077 | $2,544 |
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 Copay after deductible |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $15.00 Copay after deductible |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | $250.00 Copay after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | $450.00 Copay per Stay after deductible |
| Outpatient Surgery Physician/Surgical Services | $130.00 Copay after deductible |
| Urgent Care Centers or Facilities | $30.00 Copay after deductible |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | No Charge after deductible |
| Non-Preferred Brand Drugs | $150.00 Copay after deductible |
| Preferred Brand Drugs | $30.00 Copay after deductible |
| Specialty Drugs | 50.00% Coinsurance after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | $450.00 Copay per Stay after deductible |
| Mental Health Other | 20.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | $15.00 Copay after deductible |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | 20.00% Coinsurance after deductible |
| Acupuncture | Not covered |
| Allergy Testing | $15.00 Copay after deductible |
| Bariatric Surgery | 20.00% Coinsurance after deductible |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | 20.00% Coinsurance after deductible |
| Chemotherapy | 20.00% Coinsurance after deductible |
| Chiropractic Care | $15.00 Copay after deductible |
| Clinical Trials | 20.00% Coinsurance after deductible |
| Cosmetic Surgery | 20.00% Coinsurance after deductible |
| Delivery and All Inpatient Services for Maternity Care | $450.00 Copay after deductible |
| Dental Anesthesia | 20.00% Coinsurance after deductible |
| Dental Check-Up for Children | No charge |
| Diabetes Care Management | 20.00% Coinsurance after deductible |
| Diabetes Education | No charge |
| Dialysis | 20.00% Coinsurance after deductible |
| Durable Medical Equipment | 20.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | 20.00% Coinsurance after deductible |
| Eye Glasses for Children | No Charge after deductible |
| Habilitation Services | $15.00 Copay after deductible |
| Hearing Aids | Not covered |
| Home Health Care Services | 20.00% Coinsurance after deductible |
| Hospice Services | 20.00% Coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs) | $175.00 Copay after deductible |
| Infertility Treatment | 20.00% Coinsurance after deductible |
| Infusion Therapy | 20.00% Coinsurance after deductible |
| Inpatient Physician and Surgical Services | No Charge after deductible |
| Laboratory Outpatient and Professional Services | $15.00 Copay after deductible |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | 20.00% Coinsurance after deductible |
| Nutritional Counseling | No charge |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | 20.00% Coinsurance after deductible |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $15.00 Copay after deductible |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | $130.00 Copay after deductible |
| Outpatient Rehabilitation Services | $15.00 Copay after deductible |
| Prenatal and Postnatal Care | No Charge after deductible |
| Private-Duty Nursing | 20.00% Coinsurance after deductible |
| Prosthetic Devices | 20.00% Coinsurance after deductible |
| Radiation | 20.00% Coinsurance after deductible |
| Reconstructive Surgery | 20.00% Coinsurance after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $15.00 Copay after deductible |
| Rehabilitative Speech Therapy | $15.00 Copay after deductible |
| Routine Dental Services (Adult) | Not covered |
| Routine Eye Exam (Adult) | No charge |
| Routine Eye Exam for Children | No charge |
| Routine Foot Care | Not covered |
| Skilled Nursing Facility | $450.00 Copay per Stay after deductible |
| Substance Abuse Disorder Inpatient Services | $450.00 Copay per Stay after deductible |
| Substance Abuse Disorder Outpatient Services | $15.00 Copay after deductible |
| Transplant | 20.00% Coinsurance after deductible |
| Treatment for Temporomandibular Joint Disorders | 20.00% Coinsurance after deductible |
| Weight Loss Programs | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $15.00 Copay after deductible |
Plan rules
Service area
This plan covers 1 geographic area.
Open enrollment coming up?
Get notified when it opens — we'll remind you so you don't miss your window.