Blue Saver Silver Health Insurance Plan

Blue Saver Silver

Consider a Silver plan if you want lower monthly premiums and you use healthcare services every so often.

This plan requires you to designate a Primary Care Select Physician. You will only pay a $50 copay when visiting your designated physician.

Lower Premium

Lower Deductible

Calendar Year Deductible	$3,500 individual; $7,000 family
Out-of-Pocket Maximum	$8,150 individual; $16,300 family
Primary Care Office Visit	$50 copay. Each member must designate a Primary Care Select physician
Specialist Office Visit	$75 copay. You must have a referral from your Primary Care Select physician
Telephone and Online Video Consultations	You pay $45 per consultation
Outpatient Surgery	25% member coinsurance, after meeting the calendar year deductible
Emergency Room	25% member coinsurance, after meeting the calendar year deductible
Pediatric Routine Dental Cleaning and Yearly Eye Exam	Routine Dental Cleaning: you pay $0; Yearly Eye Exam: you pay 25% member coinsurance, after meeting the calendar year deductible
Prescription Drugs	Tier 1: $20 copay / Tier 2: $30 copay / Tiers 3-6: 25% member coinsurance, after meeting the calendar year deductible / Generic drugs are mandatory when available
Notes	This plan uses the Source+Rx 1.0 Prescription Drug List and the ValueONE Network, which does not include all major retail chains. Check the pharmacy network.