Sold outside the marketplace. This plan is bought directly from the insurer, so it is not eligible for a premium tax credit. If your income qualifies you for savings, a marketplace plan at the same price will usually cost you less.

Prosano Priority Gold

Blue Cross Blue Shield of Arizona · 2027 plan year

Gold
Ind. deductible
$1,500
Family deductible
$3,000
Ind. OOP max
$8,000
Family OOP max
$16,000

Monthly premiums by age

Rating Area 4 — the lowest-priced of the 2 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$510$510
21$667$684
30$757$776
40$853$895
50$1,192$1,281
60$1,811$1,992
64 and over$2,001$2,202

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$30.00

Specialist

BenefitIn-network
Specialist Visit$60.00

Hospital

BenefitIn-network
Emergency Room Services$1,200.00
Inpatient Hospital Services (e.g., Hospital Stay)30.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services30.00% Coinsurance after deductible
Urgent Care Centers or Facilities$60.00

Pharmacy

BenefitIn-network
Generic Drugs$3.00
Non-Preferred Brand Drugs30.00% Coinsurance after deductible
Preferred Brand Drugs$70.00 Copay after deductible
Specialty Drugs30.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services30.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$60.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental30.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing$60.00
Bariatric Surgery30.00% Coinsurance after deductible
Basic Dental Care - AdultNot covered
Basic Dental Care - Child50.00% Coinsurance after deductible
Chemotherapy30.00% Coinsurance after deductible
Chiropractic Care$60.00
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care30.00% Coinsurance after deductible
Dental Check-Up for ChildrenNo charge
Diabetes EducationNo charge
Dialysis30.00% Coinsurance after deductible
Durable Medical Equipment30.00% Coinsurance after deductible
Emergency Transportation/Ambulance30.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Habilitation Services30.00% Coinsurance after deductible
Hearing Aids30.00% Coinsurance after deductible
Home Health Care Services30.00% Coinsurance after deductible
Hospice Services30.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)30.00% Coinsurance after deductible
Infertility TreatmentNot covered
Infusion Therapy30.00% Coinsurance after deductible
Inpatient Physician and Surgical Services30.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services30.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - Child50.00% Coinsurance after deductible
Nutritional CounselingNo charge
Orthodontia - AdultNot covered
Orthodontia - Child50.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)30.00% Coinsurance after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)30.00% Coinsurance after deductible
Outpatient Rehabilitation Services30.00% Coinsurance after deductible
Prenatal and Postnatal Care30.00% Coinsurance after deductible
Private-Duty Nursing30.00% Coinsurance after deductible
Prosthetic Devices30.00% Coinsurance after deductible
Radiation30.00% Coinsurance after deductible
Reconstructive Surgery30.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy30.00% Coinsurance after deductible
Rehabilitative Speech Therapy30.00% Coinsurance after deductible
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility30.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services30.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$60.00
Transplant30.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders30.00% Coinsurance after deductible
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging30.00% Coinsurance after deductible

Service area

This plan covers 2 geographic areas.

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