MVN East Bronze Connect HSA 6250
Blue Cross of Idaho · 2026 plan year
Expanded BronzeHSA eligible
- Ind. deductible
- $6,250
- Family deductible
- $6,250
- Ind. OOP max
- $7,500
- Family OOP max
- $7,500
Compare with other Expanded Bronze plans in ID
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More Blue Cross of Idaho plans in ID
Monthly premiums by age
Rating Area 4 — the lowest-priced of the 2 areas this plan covers. Premiums differ by area.
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $220 | $220 |
| 21 | $288 | $345 |
| 30 | $327 | $392 |
| 40 | $368 | $441 |
| 50 | $514 | $617 |
| 60 | $781 | $937 |
| 64 and over | $863 | $1,036 |
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 | 20.00% Coinsurance after deductible |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | 20.00% Coinsurance after deductible |
Hospital
| Benefit | In-network |
|---|---|
| Inpatient Hospital Services (e.g., Hospital Stay) | 20.00% Coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | 20.00% Coinsurance after deductible |
| Urgent Care Centers or Facilities | 20.00% Coinsurance after deductible |
| Emergency Room Services | $350.00 Copay after deductible + 20.00% Coinsurance after deductible |
Pharmacy
| Benefit | In-network |
|---|---|
| Non-Preferred Brand Drugs | $50.00 Copay after deductible |
| Preferred Brand Drugs | $30.00 Copay after deductible |
| Specialty Drugs | 50.00% Coinsurance after deductible |
| Generic Drugs | $10.00 Copay after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 20.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | 20.00% Coinsurance after deductible |
Other
| Benefit | In-network |
|---|---|
| Inpatient Physician and Surgical Services | 20.00% Coinsurance after deductible |
| Laboratory Outpatient and Professional Services | 20.00% Coinsurance after deductible |
| Nutritional Counseling | No charge |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | 20.00% Coinsurance after deductible |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 20.00% Coinsurance after deductible |
| Outpatient Rehabilitation Services | 20.00% Coinsurance after deductible |
| Prenatal and Postnatal Care | 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 | 20.00% Coinsurance after deductible |
| Rehabilitative Speech Therapy | 20.00% Coinsurance after deductible |
| Routine Eye Exam for Children | No charge |
| Skilled Nursing Facility | 20.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | 20.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | 20.00% Coinsurance after deductible |
| Transplant | 20.00% Coinsurance after deductible |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | 20.00% Coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs) | $250.00 + 20.00% Coinsurance after deductible |
| Infusion Therapy | 20.00% Coinsurance after deductible |
| Habilitation Services | 20.00% Coinsurance after deductible |
| Hearing Aids | 20.00% Coinsurance after deductible |
| Home Health Care Services | 20.00% Coinsurance after deductible |
| Hospice Services | No Charge after deductible |
| Accidental Dental | 20.00% Coinsurance after deductible |
| Allergy Testing | 20.00% Coinsurance after deductible |
| Chemotherapy | 20.00% Coinsurance after deductible |
| Chiropractic Care | 20.00% Coinsurance after deductible |
| Delivery and All Inpatient Services for Maternity Care | 20.00% Coinsurance after deductible |
| Diabetes Education | 20.00% Coinsurance after deductible |
| 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 |
Service area
This plan covers 10 geographic areas.
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