Blue Cross and Blue Shield of Montana (BCBSMT) has an individual portfolio designed to:
- Optimize product offering
- Control escalating medical costs
- Lower cost barriers to care for members
- Focus on providing a variety of benefit features to a broad base
- Help ensure compliance with regulations
- Sustain product offering amid changing legislation
Individual Plan Portfolio
(On and Off Marketplace)
Blue Preferred PPO: 4 Bronze, 3 Silver, 1 Gold
- Choice of doctors and hospitals throughout the state
- Traditionally higher monthly premiums than POS plans
- Network consists of roughly 66 hospitals and 9,155 providers1
Blue Focus POS: 2 Bronze, 2 Silver, 1 Gold
- Point of Service product
- May have lower premium cost than PPO plans
- Network costs of roughly 8 hospitals and 1,927 providers.1
Available in Carbon, Lake, Missoula, Musselshell, Stillwater, Sweetgrass and Yellowstone counties.
- Coverage for cleanings, preventive services and much more
- Preventive dental services deductible waived
Prescription and Pharmacy
- Six prescription payment level tiers — generic, brand and specialty drugs now have preferred and non-preferred benefit levels.
- All plans include a drug list and Value Pharmacy Network.2
Pediatric Vision Benefits
- Provides one exam, frames and contacts at no cost on some plans.
To help you make an informed decision, a Summary of Benefits and Coverage (SBC) document is available for each of our individual and family health insurance plans. It describes key features such as:
- Covered benefits
- Cost-sharing provisions
- Coverage limitations
We encourage you to learn more about our plans and to see which plan fits the needs of your prospect.
If you’re a producer interested in helping individuals learn about health coverage options, visit our Individual Coverage Certification page.
If you are already a Blue Cross and Blue Shield of Montana (BCBSMT) producer we encourage you to log in to our secure producer portal Blue Access for ProducersSM (BAPSM) for more tools and information:
- Obtain an instant preliminary quote whenever a client calls
- View, download, or print the information you need
- View product information
- Manage your group and individual business
All information represents an overview of coverage. It's not a complete list of what is covered or excluded. Information is subject to change. The full terms of coverage are located in the insurance policy.
1 Estimates as of 9/1/2019.
2 A “value” or “participating” pharmacy has a contract with BCBSMT's pharmacy benefit manager to provide pharmacy services at a negotiated rate. A pharmacy benefit manager administers prescription drug benefits for a health plan. The terms “value” and “participating” should not be construed as a recommendation, referral or any other statement as to the ability or quality of such pharmacy.