Gold Plans

To help you compare all of the gold plans, we are providing the Summary of Benefits and Coverage (SBC) documents below. These SBCs describe key features such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions.

All gold plans offer the same set of essential health benefits, quality and amount of care. The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are.

Gold Plans have a higher monthly premium and often lower out-of-pocket costs than silver plans. In most cases, gold plans cover 80% of costs, while you cover 20%.

Information in these SBCs represents an overview of coverage. It is 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.

Plan Details

• View Plan Pricing
• Compare Marketplace Gold Plans
• Compare Individual Gold Plans
• Texas Plan Overview

Blue Choice Gold PPO Plans

Blue Choice Gold PPO 001	Blue Choice Gold PPO 002
On the Exchange	On the Exchange
Blue Choice Gold PPO 001 – Base Plan ($3250/$3250)	Blue Choice Gold PPO 002 – Base Plan ($1500/$3500)
Blue Choice Gold PPO 001 – American Indian Zero ($0/$0)	Blue Choice Gold PPO 002 – American Indian Zer ($0/$0)
Blue Choice Gold PPO 001 – American Indian Limited ($3250/$3250)	Blue Choice Gold PPO 002 – American Indian Limited ($1500/$3500)
Off the Exchange	Off the Exchange
Blue Choice Gold PPO 001 – ($3250 / $3250)	Blue Choice Gold PPO 002 – ($1500 / $3500)
Blue Choice Gold PPO 011
Off the Exchange
Blue Choice Gold PPO 011 – ($1000 / $3000)

Blue Advantage Gold HMO Plans

Blue Advantage Gold HMO 001 *	Blue Advantage Gold HMO 002 *
On the Exchange	On the Exchange
Blue Advantage Gold HMO 001 – Base Plan ($3250/$3250)	Blue Advantage Gold HMO 002 – Base Plan ($1500/$3500)
Blue Advantage Gold HMO 001 – American Indian Zero ($0/$0)	Blue Advantage Gold HMO 002 – American Indian Zero ($0/$0)
Blue Advantage Gold HMO 001 – American Indian Limited ($3250/$3250)	Blue Advantage Gold HMO 002 – American Indian Limited ($1500/$3500)
Off the Exchange	Off the Exchange
Blue Advantage Gold HMO 001 – ($3250 / $3250)	Blue Advantage Gold HMO 002 – ($1500 / $3500)
Blue Advantage Gold HMO 007 *	Blue Advantage Gold HMO 008
Off the Exchange	Off the Exchange
Blue Advantage Gold HMO 007 – ($1000 / $3000)	Blue Advantage Gold HMO 008 – ($0 / $6000)

*Texas Department of Insurance required Disclosure Notice for all individual HMO Consumer Choice benefit plans issued in Texas. This notice explains that the individual HMO plans noted above have a higher deductible or greater cost-sharing than what is required by Texas state law. Because of this, these plans may have fewer benefits and a lower monthly premium than a plan that meets the Texas requirements.

Multi-State Plan Program Individual Plans

Blue Cross Blue Shield Premier 1	Blue Cross Blue Shield Premier 2
On the Exchange	On the Exchange
BCBS Premier 1, a Multi-State Plan - Base Plan - ($1000/$2750)	BCBS Premier 2, a Multi-State Plan - Base Pan - ($500/$4000)
BCBS Premier 1, a Multi-State Plan - American Indian Zero - ($0/$0)	BCBS Premier 2, a Multi-State Plan - American Indian Zero - ($0/$0)
BCBS Premier 1, a Multi-State Plan - American Indian Limited - ($1000/$2750)	BCBS Premier 2, a Multi-State Plan - American Indian Limited - ($500/$4000)