Blue Plus Minnesota Value Silver CSR Plan 401d

HMO Minnesota dba Blue Plus · 2027 plan year

Silver

Ind. deductible: $300
Family deductible: $600
Ind. OOP max: $3,200
Family OOP max: $6,400

Other cost-sharing reduction variants for this plan:

73% AV Level Silver Plan 94% AV Level Silver Plan Limited Cost Sharing Plan Variation Standard Silver Off Exchange Plan Standard Silver On Exchange Plan Zero Cost Sharing Plan Variation

More HMO Minnesota dba Blue Plus plans in MN

Blue Plus Metro MN Silver HSA Plan 453 Blue Plus Metro MN Gold Rx Copay Plan 455 Blue Plus Metro MN Bronze HSA Plan 458 Blue Plus Metro MN Bronze HSA Plan 458

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	35.00% Coinsurance after deductible

Specialist

Benefit	In-network
Specialist Visit	35.00% Coinsurance after deductible

Hospital

Benefit	In-network
Emergency Room Services	35.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	35.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	35.00% Coinsurance after deductible
Urgent Care Centers or Facilities	35.00% Coinsurance after deductible

Pharmacy

Benefit	In-network
Generic Drugs	35.00% Coinsurance after deductible
Non-Preferred Brand Drugs	50.00% Coinsurance after deductible
Preferred Brand Drugs	35.00% Coinsurance after deductible
Specialty Drugs	50.00% Coinsurance after deductible

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	35.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	35.00% Coinsurance after deductible

Other

Benefit	In-network
Abortion for Which Public Funding is Prohibited	35.00% Coinsurance after deductible
Accidental Dental	35.00% Coinsurance after deductible
Allergy Testing	35.00% Coinsurance after deductible
Chemotherapy	35.00% Coinsurance after deductible
Chiropractic Care	35.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care	35.00% Coinsurance after deductible
Diabetes Education	35.00% Coinsurance after deductible
Dialysis	35.00% Coinsurance after deductible
Durable Medical Equipment	35.00% Coinsurance after deductible
Emergency Transportation/Ambulance	35.00% Coinsurance after deductible
Eye Glasses for Children	35.00% Coinsurance after deductible
Habilitation Services	35.00% Coinsurance after deductible
Hearing Aids	35.00% Coinsurance after deductible
Home Health Care Services	35.00% Coinsurance after deductible
Hospice Services	35.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	35.00% Coinsurance after deductible
Infusion Therapy	35.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	35.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	35.00% Coinsurance after deductible
Nutritional Counseling	35.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)	35.00% Coinsurance after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	35.00% Coinsurance after deductible
Outpatient Rehabilitation Services	35.00% Coinsurance after deductible
Prenatal and Postnatal Care	No charge
Prosthetic Devices	35.00% Coinsurance after deductible
Radiation	35.00% Coinsurance after deductible
Reconstructive Surgery	35.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	35.00% Coinsurance after deductible
Rehabilitative Speech Therapy	35.00% Coinsurance after deductible
Routine Eye Exam for Children	No charge
Skilled Nursing Facility	35.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	35.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	35.00% Coinsurance after deductible
Transplant	35.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	35.00% Coinsurance after deductible
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	35.00% Coinsurance after deductible

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