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.

my Blue Access WV PPO Premier Silver 0 + Adult Dental and Vision

Highmark Blue Cross Blue Shield West Virginia · 2026 plan year

Silver
Ind. deductible
No deductible
Family deductible
$0
Ind. OOP max
$9,700
Family OOP max
$19,400

More Highmark Blue Cross Blue Shield West Virginia plans in WV

Monthly premiums by age

Rating Area 6 — the lowest-priced of the 11 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$602$602
21$787$806
30$893$915
40$1,005$1,106
50$1,405$1,721
60$2,135$2,615
64 and over$2,360$2,891

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$45.00

Specialist

BenefitIn-network
Specialist Visit$45.00

Hospital

BenefitIn-network
Emergency Room Services$1,250.00
Inpatient Hospital Services (e.g., Hospital Stay)$2500.00 Copay per Stay
Outpatient Surgery Physician/Surgical Services$1,000.00
Urgent Care Centers or Facilities$90.00

Pharmacy

BenefitIn-network
Generic Drugs$5.00
Non-Preferred Brand Drugs$250.00
Preferred Brand Drugs$30.00
Specialty Drugs50.00%

Mental Health

BenefitIn-network
Mental Health Other30.00%
Mental/Behavioral Health Inpatient Services$2500.00 Copay per Stay
Mental/Behavioral Health Outpatient Services$45.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental30.00%
AcupunctureNot covered
Allergy Testing$60.00
Bariatric Surgery30.00%
Basic Dental Care - Adult20.00%
Basic Dental Care - Child50.00%
Chemotherapy30.00%
Chiropractic Care$45.00
Clinical Trials30.00%
Cosmetic Surgery30.00%
Delivery and All Inpatient Services for Maternity Care$2,500.00
Dental Anesthesia30.00%
Dental Check-Up for ChildrenNo charge
Diabetes Care Management30.00%
Diabetes EducationNo charge
Dialysis30.00%
Durable Medical Equipment30.00%
Emergency Transportation/Ambulance30.00%
Eye Glasses for ChildrenNo charge
Habilitation Services$45.00
Hearing Aids$999.00
Home Health Care Services30.00%
Hospice Services30.00%
Imaging (CT/PET Scans, MRIs)$800.00
Infertility Treatment30.00%
Infusion Therapy30.00%
Inpatient Physician and Surgical ServicesNo charge
Laboratory Outpatient and Professional Services$60.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - Adult50.00%
Major Dental Care - Child50.00%
Nutritional CounselingNo charge
Orthodontia - AdultNot covered
Orthodontia - Child50.00%
Other Practitioner Office Visit (Nurse, Physician Assistant)$45.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)$1,000.00
Outpatient Rehabilitation Services$45.00
Prenatal and Postnatal CareNo charge
Private-Duty Nursing30.00%
Prosthetic Devices30.00%
Radiation30.00%
Reconstructive Surgery30.00%
Rehabilitative Occupational and Rehabilitative Physical Therapy$45.00
Rehabilitative Speech Therapy$45.00
Routine Dental Services (Adult)No charge
Routine Eye Exam (Adult)No charge
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility$2500.00 Copay per Stay
Substance Abuse Disorder Inpatient Services$2500.00 Copay per Stay
Substance Abuse Disorder Outpatient Services$45.00
Transplant30.00%
Treatment for Temporomandibular Joint Disorders30.00%
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging$175.00

Service area

This plan covers 1 geographic area.

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