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.

Blue Max Copay (PCP) 50/50 $3300 with 2 $0 PCP Virtual Visits

Blue Cross and Blue Shield of Louisiana · 2026 plan year

Silver
Ind. medical deductible
$3,300
Rx deductible (separate)
$500
Family deductible
$9,900
Ind. OOP max
$9,900
Family OOP max
$19,800

This plan sets a separate deductible for prescription drugs. The medical deductible shown does not cover prescriptions; they have their own.

More Blue Cross and Blue Shield of Louisiana plans in LA

Monthly premiums by age

Rating Area 2 — the lowest-priced of the 8 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$595$595
21$778$895
30$883$1,015
40$994$1,143
50$1,389$1,598
60$2,111$2,428
64 and over$2,334$2,684

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$40.00

Specialist

BenefitIn-network
Specialist Visit$65.00

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$65.00

Pharmacy

BenefitIn-network
Generic Drugs$15.00 Copay after deductible
Non-Preferred Brand Drugs30.00% Coinsurance after deductible
Preferred Brand Drugs20.00% Coinsurance after deductible
Prescription Drugs Other50.00% Coinsurance after deductible
Specialty Drugs20.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$40.00

Other

BenefitIn-network
Cosmetic SurgeryNot covered
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental50.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing50.00% Coinsurance after deductible
Attention Deficit Disorder$65.00
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - Child50.00% Coinsurance after deductible
Chemotherapy50.00% Coinsurance after deductible
Chiropractic Care$40.00
Clinical Trials$65.00
Congenital Anomaly, including Cleft Lip/Palate50.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care50.00% Coinsurance after deductible
Dental Anesthesia50.00% Coinsurance after deductible
Dental Check-Up for ChildrenNo charge
Diabetes Care Management50.00% Coinsurance after deductible
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 ChildrenNo charge
Major Dental Care - Child50.00% Coinsurance after deductible
Habilitation Services50.00% Coinsurance after deductible
Hearing Aids50.00% Coinsurance after deductible
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
Inherited Metabolic Disorder - PKU50.00% 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
Non-Emergency Care When Traveling Outside the U.S.50.00% Coinsurance after deductible
Nutritional Counseling50.00% Coinsurance after deductible
Orthodontia - AdultNot covered
Orthodontia - Child50.00% Coinsurance after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)$40.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)50.00% Coinsurance after deductible
Outpatient Rehabilitation Services50.00% Coinsurance after deductible
Prenatal and Postnatal Care$65.00
Private-Duty Nursing50.00% Coinsurance after deductible
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 ChildrenNo charge
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$40.00
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

Service area

This plan covers 1 geographic area.

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