ICON Gold 1500 POS

Regence BlueShield of Idaho, Inc. · 2026 plan year

Gold

Ind. deductible: $1,500
Family deductible: $1,500
Ind. OOP max: $10,150
Family OOP max: $10,150

Other cost-sharing reduction variants for this plan:

Standard Gold Off Exchange Plan Standard Gold On Exchange Plan Zero Cost Sharing Plan Variation

More Regence BlueShield of Idaho, Inc. plans in ID

PREF Bronze HSA 7000 ICON Silver 5700 Separate RX Deductible POS ICON Silver 6500 POS ICON Gold 2300 POS

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	$10.00

Specialist

Benefit	In-network
Specialist Visit	$70.00

Hospital

Benefit	In-network
Urgent Care Centers or Facilities	$70.00
Emergency Room Services	20.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	20.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	20.00% Coinsurance after deductible

Pharmacy

Benefit	In-network
Generic Drugs	$12.00
Non-Preferred Brand Drugs	40.00% Coinsurance after deductible
Preferred Brand Drugs	20.00% Coinsurance after deductible
Specialty Drugs	50.00% Coinsurance after deductible

Mental Health

Benefit	In-network
Mental/Behavioral Health Inpatient Services	20.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	$10.00

Other

Benefit	In-network
Dialysis	20.00% Coinsurance after deductible
Well Baby Visits and Care	No charge
Diabetes Education	No charge
Dental Check-Up for Children	No charge
Accidental Dental	20.00% Coinsurance after deductible
Acupuncture	$10.00
Allergy Testing	20.00% Coinsurance after deductible
Basic Dental Care - Child	20.00%
Chemotherapy	20.00% Coinsurance after deductible
Chiropractic Care	$10.00
Delivery and All Inpatient Services for Maternity Care	20.00% Coinsurance after deductible
Durable Medical Equipment	20.00% Coinsurance after deductible
Emergency Transportation/Ambulance	20.00% Coinsurance after deductible
Eye Glasses for Children	No charge
Habilitation Services	20.00% Coinsurance after deductible
Hearing Aids	20.00% Coinsurance after deductible
Home Health Care Services	20.00% Coinsurance after deductible
Hospice Services	20.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)	20.00% Coinsurance after deductible
Infusion Therapy	20.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	20.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	20.00% Coinsurance after deductible
Major Dental Care - Child	50.00%
Nutritional Counseling	20.00% Coinsurance after deductible
Orthodontia - Child	50.00%
Other Practitioner Office Visit (Nurse, Physician Assistant)	$10.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	20.00% Coinsurance after deductible
Outpatient Rehabilitation Services	20.00% Coinsurance after deductible
Prenatal and Postnatal Care	20.00% Coinsurance after deductible
Prosthetic Devices	20.00% Coinsurance after deductible
Radiation	20.00% Coinsurance after deductible
Reconstructive Surgery	20.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	20.00% Coinsurance after deductible
Rehabilitative Speech Therapy	20.00% Coinsurance after deductible
Routine Eye Exam for Children	No charge
Skilled Nursing Facility	20.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	20.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	$10.00
Transplant	20.00% Coinsurance after deductible
X-rays and Diagnostic Imaging	20.00% Coinsurance after deductible

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