Blue Pee Dee Gold 1

BlueCross BlueShield of South Carolina · 2026 plan year

Gold
Ind. deductible
$250
Family deductible
$500
Ind. OOP max
$8,900
Family OOP max
$17,800

Compare with other Gold plans in SC

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

More BlueCross BlueShield of South Carolina plans in SC

Monthly premiums by age

Rating Area 26 — the lowest-priced of the 4 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$312$312
21$408$490
30$463$556
40$522$626
50$729$875
60$1,108$1,330
64 and over$1,225$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 Illness$25.00

Specialist

BenefitIn-network
Specialist Visit$50.00

Hospital

BenefitIn-network
Emergency Room Services50.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)50.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services50.00% Coinsurance after deductible
Urgent Care Centers or Facilities$60.00

Pharmacy

BenefitIn-network
Generic Drugs$12.00
Non-Preferred Brand Drugs50.00% Coinsurance after deductible
Preferred Brand Drugs$40.00
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$25.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental50.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing50.00% Coinsurance after deductible
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Chemotherapy50.00% Coinsurance after deductible
Chiropractic CareNot covered
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care50.00% Coinsurance after deductible
Dental Check-Up for ChildrenNot covered
Diabetes Education50.00% Coinsurance after deductible
Dialysis50.00% Coinsurance after deductible
Durable Medical Equipment50.00% Coinsurance after deductible
Emergency Transportation/Ambulance50.00% Coinsurance after deductible
Eye Glasses for Children$50.00
Habilitation Services50.00% Coinsurance after deductible
Hearing AidsNot covered
Home Health Care Services50.00% Coinsurance after deductible
Hospice Services50.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)50.00% Coinsurance after deductible
Infertility TreatmentNot covered
Infusion Therapy50.00% Coinsurance after deductible
Inpatient Physician and Surgical Services50.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services50.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutritional Counseling50.00% Coinsurance after deductible
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$25.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)50.00% Coinsurance after deductible
Outpatient Rehabilitation Services50.00% Coinsurance after deductible
Prenatal and Postnatal Care50.00% Coinsurance after deductible
Private-Duty NursingNot covered
Prosthetic Devices50.00% Coinsurance after deductible
Radiation50.00% Coinsurance after deductible
Reconstructive Surgery50.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy50.00% Coinsurance after deductible
Rehabilitative Speech Therapy50.00% Coinsurance after deductible
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for Children$25.00
Routine Foot CareNot covered
Skilled Nursing Facility50.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services50.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$25.00
Transplant50.00% Coinsurance after deductible
Treatment for Temporomandibular Joint DisordersNot covered
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging50.00% Coinsurance after deductible

Plan rules

Service area

This plan covers 4 geographic areas.

Open enrollment coming up?

Get notified when it opens — we'll remind you so you don't miss your window.