Highmark Blue Cross Blue Shield High Deductible Rates

Highmark Blue Cross Blue Shield provides a comprehensive qualified high deductible plan in Western Pennsylvania. It is an “HSA-friendly” plan so it can be used in conjunction with a Health Savings Account. The PPO Blue plan is a perfect fit for the self employed, families or individuals that want quality coverage at a reasonable price. As a medically underwritten policy, applying for coverage will require a simple application to be completed, but a face-to-face meeting is not necessary. The PPO Blue, Advance Blue and Simply Blue provide Pa residents with three great choices.

How Does It Work?

There are numerous deductible options. For example, if coverage is for just one person, you may select a deductible as low as $1,250 or as high as $3,500. The family deductible range is $2,500 to $7,000. As you may expect, a lower amount will result in higher pricing, since there is less potential out of pocket cost to the customer and more for the insurer.

All preventive treatment is paid in full with no copays. A full list of covered items is available through the Department of Health and Human Services or we can email you a full listing. Most other treatment is provided at negotiated repricing, meaning that until the deductible is met, you receive a substantial discount in cost, courtesy of Highmark. The discounts may range from 5%-20% (office visits) to as much as 50%-85% (lab tests and other diagnostic expenses).

The responsibility of the policyholder is 10% once the deductible has been met. This includes all benefits including prescriptions and hospital and facility charges. Maternity benefits are also considered a covered expense, which is unusual for these types of policies. However, the new law requires additional mandates on all new policies issued in 2014.

HealthInsurance 150x150 Highmark Blue Cross Blue Shield High Deductible Rates

Guaranteed Approval Through Pa Health Insurance Exchange

We’ll help you determine which option covers your needs best at the most affordable rate. With our 30 years of experience and unbiased advice,  you can be confident that you’ll fully understand  details and the application process will be simple and quick.Whether you purchase a plan inside or outside of the State Exchange, our website will simplify the process for you.

How to use these charts:

• For an individual: single male, age 25; no spouse or children; $3,500 deductible. Based on the individual’s gender, the rate is taken from the Male rate chart, $3,500 Individual Deductible, for age 25. This individual’s monthly rate is $57.10.

Monthly Rates Female

Age$1,200 Deductible$2,600 Deductible$3,500 Deductible
<19$66.45$58.20$54.75
19–24$104.20$90.00$84.10
25–29$130.20$111.90$104.30
30–34$158.30$135.60$126.15
35–39$158.35$135.65$126.20
40–44$161.00$137.85$128.25
45–49$179.50$153.45$142.65
50–54$211.45$180.40$167.45
55–59$242.10$206.25$191.30
60–64$284.75$242.20$224.45

Monthly Rates Male

Age$1,200 Deductible$2,600 Deductible$3,500 Deductible
<19$66.45$58.20$54.75
19–24$66.45$58.20$54.75
25–29$69.45$60.75$57.10
30–34$79.75$69.40$65.10
35–39$95.00$82.25$76.95
40–44$114.10$98.35$91.80
45–49$143.30$122.95$114.45
50–54$184.45$157.65$146.50
55–59$243.30$207.25$192.25
60–64$329.05$279.50$258.85

PPOBlue Preferred-Provider High-Deductible Program

$2,400 Family Annual Deductible

How to Apply the PPOBlue Family Deductible

For an Agreement covering more than one (1) family member, the ENTIRE family deductible must be met (within a benefit period) before Highmark will pay for covered services for ANY family member. The family deductible can be satisfied by an individual family member or a combination of one or more family members.

How to use these charts:

• For a family of four: father, age 51; mother, age 48; son, age 18; daughter, age 15. Based on the father’s gender and as the older spouse, the rate is taken from the Male rate chart for age 51. Under the Husband/Wife/Children category, this family’s monthly rate is $525.60.

Monthly Rates Female

Parent/ChildrenHusband/WifeHusband/Wife/ChildHusband/Wife/Children
<19$122.45$197.20$170.65$225.85$300.35
19–24$160.20$234.95$170.65$225.85$300.35
25–29$186.20$260.95$199.65$254.90$329.35
30–34$214.35$289.10$238.05$293.30$367.75
35–39$214.35$289.10$253.35$308.55$383.05
40–44$217.00$291.75$275.10$330.30$404.80
45–49$235.50$310.25$322.80$378.00$452.45
50–54$267.45$342.20$395.90$451.10$525.60
55–59$298.15$372.90$485.40$540.65$615.15
60–64$340.80$415.55$613.80$669.05$743.50

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Monthly Rates Male

ChildParent/ChildrenHusband/WifeHusband/Wife/ChildHusband/Wife/Children
<19$122.45$197.20$170.65$225.85$300.35
19–24$122.45$197.20$170.65$225.85$300.35
25–29$125.50$200.20$199.65$254.90$329.35
30–34$135.75$210.50$238.05$293.30$367.75
35–39$151.00$225.75$253.35$308.55$383.05
40–44$170.15$244.90$275.10$330.30$404.80
45–49$199.30$274.05$322.80$378.00$452.45
50–54$240.45$315.20$395.90$451.10$525.60
55–59$299.35$374.10$485.40$540.65$615.15
60–64$385.05$459.80$613.80$669.05$743.50

PPOBlue Preferred-Provider High-Deductible Program

$5,200 Family Annual Deductible

How to Apply the PPOBlue Family Deductible

For an Agreement covering more than one (1) family member, the ENTIRE family deductible must be met (within a benefit period) before Highmark will pay for covered services for ANY family member. The family deductible can be satisfied by an individual family member or a combination of one or more family members.

How to use these charts:

• For a family of four: father, age 51; mother, age 48; son, age 18; daughter, age 15. Based on the father’s gender and as the older spouse, the rate is taken from the Male rate chart for age 51. Under the Husband/Wife/Children category, this family’s monthly rate is $450.20.

 

Monthly Rates Female

Parent/ChildrenHusband/WifeHusband/Wife/ChildHusband/Wife/Children
<19$106.90$171.40$148.20$196.10$260.35
19–24$138.70$203.20$148.20$196.10$260.35
25–29$160.60$225.15$172.65$220.55$284.80
30–34$184.30$248.80$205.00$252.90$317.15
35–39$184.35$248.85$217.90$265.80$330.05
40–44$186.55$251.05$236.20$284.10$348.35
45–49$202.15$266.65$276.40$324.30$388.55
50–54$229.10$293.60$338.05$385.95$450.20
55–59$254.95$319.45$413.50$461.35$525.60
60–64$290.90$355.40$521.70$569.55$633.80

Monthly Rates Male

Parent/ChildrenHusband/WifeHusband/Wife/ChildHusband/Wife/Children
<19$106.90$171.40$148.20$196.10$260.35
19–24$106.90$171.40$148.20$196.10$260.35
25–29$109.45$173.95$172.65$220.55$284.80
30–34$118.10$182.60$205.00$252.90$317.15
35–39$130.95$195.45$217.90$265.80$330.05
40–44$147.05$211.55$236.20$284.10$348.35
45–49$171.65$236.15$276.40$324.30$388.55
50–54$206.35$270.85$338.05$385.95$450.20
55–59$255.95$320.45$413.50$461.35$525.60
60–64$328.20$392.70$521.70$569.55$633.80

PPOBlue Preferred-Provider High-Deductible Program $7,000 Family Annual Deductible

How to Apply the PPOBlue Family Deductible

For an Agreement covering more than one (1) family member, the ENTIRE family deductible must be met (within a benefit period) before Highmark will pay for covered services for ANY family member. The family deductible can be satisfied by an individual family member or a combination of one or more family members.

How to use these charts:

• For a family of four: father, age 51; mother, age 48; son, age 18; daughter, age 15. Based on the father’s gender and as the older spouse, the rate is taken from the Male rate chart for age 51. Under the Husband/Wife/Children category, this family’s monthly rate is $418.80.

 

Monthly Rates Female

AgeParent/ChildParent/ChildrenHusband/WifeHusband/Wife/ChildHusband/Wife/Children
<19$100.40$160.65$138.85$183.70$243.70
19–24$129.75$190.00$138.85$183.70$243.70
25–29$149.95$210.20$161.40$206.25$266.25
30–34$171.85$232.05$191.25$236.10$296.10
35–39$171.85$232.10$203.15$248.00$307.95
40–44$173.90$234.15$220.05$264.90$324.90
45–49$188.30$248.55$257.10$301.95$361.95
50–54$213.15$273.35$313.95$358.80$418.80
55–59$236.95$297.20$383.55$428.40$488.35
60–64$270.10$330.35$483.30$528.20$588.15

Monthly Rates Male

Parent/ChildParent/ChildrenHusband/WifeHusband/Wife/ChildHusband/Wife/Children
<19$100.40$160.65$138.85$183.70$243.70
19–24$100.40$160.65$138.85$183.70$243.70
25–29$102.75$163.00$161.40$206.25$266.25
30–34$110.75$171.00$191.25$236.10$296.10
35–39$122.60$182.85$203.15$248.00$307.95
40–44$137.45$197.70$220.05$264.90$324.90
45–49$160.15$220.35$257.10$301.95$361.95
50–54$192.15$252.40$313.95$358.80$418.80
55–59$237.90$298.15$383.55$428.40$488.35
60–64$304.55$364.75$483.30$528.20$588.15

 

To apply for coverage, request an application by calling (888) 513 6446 or email us at eharris@pahealthinsurancecoverage.com You can also print the application by clicking on this link and emailing (see above) or faxing to (888) 513 6446.

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Posted on: 5 Comments

5 Responses

  1. Bob C says:

    Solid prices. I applied!

  2. Geri says:

    Pittsburgh rates are good. I just moved from down South and rates are much higher. Go Steelers and Big Ben!!!

  3. Paul J Frieson says:

    I was not aware that Highmark plans cover maternity. I read the brochure and also am curious how steep network reductions are. It seems as if they could be very substantial.

  4. Ed Harris says:

    Hi Paul.

    They are substantial for X-rays and lab tests. Not too bad on most other things too!

    Ed

  5. Jack says:

    Hi, I ( we, husband, wife, child ) live in south central Pa. Fulton Co. With these ins plans do we need to visit Pa doctors only ?? We only live 2 miles from Maryland and about all of our work & shopping & current doctors are there. Thanks, Jack