2017 Individual and Family Plans

While deciding on your 2017 Individual and Family Health Care Plan, use this checklist to review what our plans offer. You can learn about:

You can also view our plan brochure to help you get started, or learn more about our plans.

View Plans and Pricing

See what health care plans are available in your area.

If you’re renewing your current health plan, here are tools and tips for next year. Opens in new window

Plan Networks and Levels

Plan Networks

Different health care plans use certain groups of doctors, hospitals and other health care professionals, known as networks, who provide a full range of covered health care services. Networks differ from plan to plan. Before you choose a plan, you may want to check if your doctor or hospital is in the network.

Blue Focus POSSM

Blue Preferred PPOSM

Plan Levels

We have three levels of health care plans available – bronze, silver, gold and platinum. All of our plans follow the Affordable Care Act (ACA) rules and give you the same set of essential health benefits, quality and amount of care (cost of the benefits differ).

Bronze Plans

  • We pay 60%
  • You pay 40%

Silver Plans

  • We pay 70%
  • You pay 30%

Gold Plans

  • We pay 80%
  • You pay 20%

Financial Assistance

When shopping for a new health insurance plan, you may qualify for help with the cost of buying coverage by:

  • Lowering your premiums through a premium tax credit
  • Qualifying for help with out-of-pocket costs
  • Getting low or no-cost coverage through a government program

Shopping Assistance

Thank you for looking at coverage options from BCBSMT. We’re here to help you get the 2017 coverage – and information – you need.

Essential Health Benefits

Every one of our health care plans cover these essential health benefits:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health disorder services
  • Substance use disorder services
  • Prescription drugs
  • Rehabilitative services and devices
  • Laboratory services
  • Preventive and wellness services
  • Chronic disease management
  • Pediatric services

Preventive Services

Many long-term illnesses can be prevented or managed when found early. With the Affordable Care Act, most health insurance plans must cover a range of preventive services with no out-of-pocket costs like a copayment or coinsurance. Services include certain screenings, immunizations, and other types of care, like:

  • Blood pressure, diabetes and cholesterol tests
  • Many cancer tests, such as mammograms and colonoscopies
  • Help to stop smoking, lose weight, fight depression and reduce alcohol abuse
  • Well-baby and well-child visits, from birth to age 21
  • Vaccines, such as measles and polio
  • Care for healthy pregnancies
  • Flu and pneumonia shots
  • Important Details

Services are covered only when you see a doctor in your health plan network.

You may have to pay all or part of the cost for preventive services if your insurance plan is grandfathered.

See a full list of covered Preventive Services

Dental and Prescription Drug Coverage

When you apply for a health plan, you may be able to enroll in a dental plan. With our dental plans, you will get one of the highest maximum annual benefit levels available per person per year.

And, with prescription drug coverage, your insurance may help pay for your medicine. Based on your coverage, you may pay either a fixed dollar amount (copayment) or a percentage (coinsurance) of your prescription drug costs. Your prescription drug benefits include mail order pharmacy services and:

  • A broad pharmacy network
  • Access to online tools for managing your prescription drugs
  • A preferred drug list
  • Generic drug or lower-cost preferred drug benefits

24/7 Non-Emergency Care Options

If you’re not having a medical emergency, you have several options for care that are available 24 hours a day, seven days a week, like:

  • 24/7 Nurseline – When calling the number on the back of your member ID card, registered nurses will ask about your condition and may recommend where to go for care (if needed).
  • Provider Finder® – Our online Provider Finder® tool Opens in new window lets you find in-network doctors and hospitals in your area.
  • Virtual Visits, Powered by MDLIVE – Interact with independently contracted MDLIVE board-certified doctors where – and when – you need it. Learn more about virtual visits.
  1. Internet/Wi-Fi connection is needed for computer access. Data charges may apply. Check your cellular data or internet service provider's plan for details. Non-emergency medical service in Idaho, Montana and New Mexico is limited to interactive audio/video (video only), along with the ability to prescribe. Non-emergency medical service in Arkansas is limited to interactive audio/video (video only) for initial consultation, along with the ability to prescribe. Behavioral health service is limited to interactive audio/video (video only), along with the ability to prescribe in all states. Service availability depends on location at the time of consultation.

    Virtual visits, powered by MDLIVE, may not be available on all plans. Virtual visits are subject to the terms and conditions of your benefit plan, including benefits, limitations, and exclusions. MDLIVE operates subject to state regulations and may not be available in certain states. MDLIVE is not an insurance product or a prescription fulfillment warehouse. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA-controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. MDLIVE physicians reserve the right to deny care for potential misuse of services.

    MDLIVE operates and administers the virtual visit program and is solely responsible for its operations and that of its contracted providers. MDLIVE® and the MDLIVE logo are registered trademarks of MDLIVE, Inc. and may not be used without written permission.

    Blue Cross®, Blue Shield® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.

View Plans and Pricing

See what health care plans are available in your area.