Blue Plus Minnesota Value Gold HSA Plan 407

HMO Minnesota dba Blue Plus · 2027 plan year

GoldHSA eligible
Ind. deductible
$3,500
Family deductible
$10,500
Ind. OOP max
$6,000
Family OOP max
$12,000

Compare with other Gold plans in MN

Side by side: deductibles, out-of-pocket limits and copays.

More HMO Minnesota dba Blue Plus plans in MN

Monthly premiums by age

Rating Area 9

AgeIndividual
Under 15$436
21$490
30$556
40$626
50$875
60$1,330
64 and over$1,470

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness5.00% Coinsurance after deductible

Specialist

BenefitIn-network
Specialist Visit5.00% Coinsurance after deductible

Hospital

BenefitIn-network
Emergency Room Services5.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)5.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services5.00% Coinsurance after deductible
Urgent Care Centers or Facilities5.00% Coinsurance after deductible

Pharmacy

BenefitIn-network
Generic Drugs5.00% Coinsurance after deductible
Non-Preferred Brand Drugs20.00% Coinsurance after deductible
Preferred Brand Drugs5.00% Coinsurance after deductible
Specialty Drugs20.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services5.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services5.00% Coinsurance after deductible

Other

BenefitIn-network
Abortion for Which Public Funding is Prohibited5.00% Coinsurance after deductible
Accidental Dental5.00% Coinsurance after deductible
Allergy Testing5.00% Coinsurance after deductible
Chemotherapy5.00% Coinsurance after deductible
Chiropractic Care5.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care5.00% Coinsurance after deductible
Diabetes Education5.00% Coinsurance after deductible
Dialysis5.00% Coinsurance after deductible
Durable Medical Equipment5.00% Coinsurance after deductible
Emergency Transportation/Ambulance5.00% Coinsurance after deductible
Eye Glasses for Children5.00% Coinsurance after deductible
Habilitation Services5.00% Coinsurance after deductible
Hearing Aids5.00% Coinsurance after deductible
Home Health Care Services5.00% Coinsurance after deductible
Hospice Services5.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)5.00% Coinsurance after deductible
Infusion Therapy5.00% Coinsurance after deductible
Inpatient Physician and Surgical Services5.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services5.00% Coinsurance after deductible
Nutritional Counseling5.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)5.00% Coinsurance after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)5.00% Coinsurance after deductible
Outpatient Rehabilitation Services5.00% Coinsurance after deductible
Prenatal and Postnatal CareNo charge
Prosthetic Devices5.00% Coinsurance after deductible
Radiation5.00% Coinsurance after deductible
Reconstructive Surgery5.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy5.00% Coinsurance after deductible
Rehabilitative Speech Therapy5.00% Coinsurance after deductible
Routine Eye Exam for ChildrenNo charge
Skilled Nursing Facility5.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services5.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services5.00% Coinsurance after deductible
Transplant5.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders5.00% Coinsurance after deductible
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging5.00% Coinsurance after deductible

Service area

This plan covers 8 geographic areas.

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