Blue Advantage Plus Gold℠ - Balance
Blue Cross and Blue Shield of Texas · 2027 plan year
Gold
- Ind. deductible
- $2,500
- Family deductible
- $5,000
- Ind. OOP max
- $8,600
- Family OOP max
- $17,200
Compare with other Gold plans in TX
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
Monthly premiums by age
Rating Area 24
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $538 | $538 |
| 21 | $703 | $703 |
| 30 | $798 | $905 |
| 40 | $898 | $1,158 |
| 50 | $1,255 | $1,659 |
| 60 | $1,907 | $2,450 |
| 64 and over | $2,108 | $2,708 |
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 | No charge |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $50.00 |
Hospital
| Benefit | In-network |
|---|---|
| Urgent Care Centers or Facilities | $30.00 |
| Emergency Room Services | $1,000.00 |
| 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 |
|---|---|
| Specialty Drugs | 50.00% Coinsurance after deductible |
| Generic Drugs | $15.00 |
| Non-Preferred Brand Drugs | 45.00% Coinsurance after deductible |
| Preferred Brand Drugs | $50.00 |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 20.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | No charge |
Other
| Benefit | In-network |
|---|---|
| Substance Abuse Disorder Inpatient Services | 20.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | No charge |
| Transplant | 20.00% Coinsurance after deductible |
| Treatment for Temporomandibular Joint Disorders | 20.00% Coinsurance after deductible |
| Weight Loss Programs | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | 20.00% Coinsurance after deductible |
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | 20.00% Coinsurance after deductible |
| Acupuncture | Not covered |
| Allergy Testing | 20.00% Coinsurance after deductible |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | Not covered |
| Chemotherapy | 20.00% Coinsurance after deductible |
| Chiropractic Care | 20.00% Coinsurance after deductible |
| Cosmetic Surgery | Not covered |
| Delivery and All Inpatient Services for Maternity Care | 20.00% Coinsurance after deductible |
| Dental Check-Up for Children | Not covered |
| Diabetes Education | 20.00% Coinsurance after deductible |
| Dialysis | 20.00% Coinsurance after deductible |
| Durable Medical Equipment | 20.00% Coinsurance after deductible |
| 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 |
| Infertility Treatment | Not covered |
| 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 |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | Not covered |
| Emergency Transportation/Ambulance | 20.00% Coinsurance after deductible |
| Eye Glasses for Children | No charge |
| Nutritional Counseling | Not covered |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | Not covered |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $50.00 |
| 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 | No charge |
| Private-Duty Nursing | Not covered |
| 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 Dental Services (Adult) | Not covered |
| Routine Eye Exam (Adult) | Not covered |
| Routine Eye Exam for Children | No charge |
| Routine Foot Care | Not covered |
| Skilled Nursing Facility | 20.00% Coinsurance after deductible |
Plan rules
Service area
This plan covers 12 geographic areas.
Open enrollment coming up?
Get notified when it opens — we'll remind you so you don't miss your window.