Copays made simple.
Learn more about BlueSimplicity.
You asked for easier-to-understand plans, predictable costs and more control. That’s what you get with BlueSimplicity. We’ve taken the guesswork out of health care costs, so you can know before you go to the doctor.
Medical services are broken out into levels ranging from free, preventive exams to hospitalization. No more deductible or coinsurance, just the copay.
Copays for prescription drugs are also based on levels, graded by safety, effectiveness and cost. Level 1 drugs are free, while Level 5 drugs will cost the most out-of-pocket.
Levels and copays for drugs
Level Silver Gold
(Available for small groups only)
Level 1 Medication $0 $0
Level 2 Medication Up to $30 Up to $15
Level 3 Medication Up to $125 Up to $60
Level 4 Medication Up to $225 Up to $150
Level 5 Medication Up to $350 Up to $250
Out-of-Pocket Maximums combined for medical services and drugs
Details Silver Gold
(Available for small groups only)
Single $7,150 $5,000
Family $14,300 $10,000
Important: Amounts shown are for illustrative purposes only. Your actual out-of-pocket cost may vary. Your actual out-of-pocket cost depends on the services you actually receive, the benefits of your plan, whether you have met your out-of-pocket maximum, the diagnosis and procedure codes submitted by your provider/s, whether your provider/s are in-network, and the quantity or supply of drugs you receive and the amount charged by the provider. Your visit to a hospital, surgical center, treatment facility or physician’s office may involve multiple claims from multiple providers resulting in additional out-of-pocket expenses. Your out-of-pocket costs may vary depending on the place your services were performed. The BlueSimplicity Copay Estimator is not available for the BlueSimplicity HSA plans or any other Individual or Small Group plan. This information is not a guarantee of payment for any claim. See your benefit certificate or coverage manual for benefits, exclusions and limitations.