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Silver health plan options

2023 ACA Plan Comparison Guide | Iowa Small Group Plans

With a silver tier, overall Wellmark pays about 70 percent and your employees will pay about 30 percent of the plan's cost-sharing requirements, which can include the deductible, coinsurance and copays. Consider a silver plan if you want to balance monthly premium costs vs. out-of-pocket expenses for your employees when they receive care.

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Silver plan details

Regardless of the network you choose, all plans below are available. Amounts in the table reflect covered, in-network services only. For PPO and POS plans, additional cost shares will apply to out-of-network services. All plans include easy-to-navigate pharmacy benefits with Blue Rx EssentialsSM. Blue Rx Essentials prescription tiers are designated based on factors like cost and effectiveness when compared to similar drugs.

myBlue HDHPSM Silver CompleteBlueSM 4000 CompleteBlueSM 5000 CompleteBlueSM Primary
Medical deductible — annual amount you pay before Wellmark pays
Single $5,000 $4,000 $5,000 $5,800
Family $10,000 $8,000 $10,000 $11,600
Coinsurance — portion of medical cost you pay after your deductible is met 0% 30% 30% 30%
Out-of-pocket maximum (OPM) — the most you'll spend in a year
Single $5,000 $9,000 $9,000 $8,900
Family $10,000 $18,000 $18,000 $17,800
Medical benefits
Preventive care screenings Free Free Free Free
Virtual visits Deductible$0 $0 $0
Primary care office services $40 $50 $15
Non-primary care office services $100 $100 $100
Emergency room visit $700 $600 Deductible plus 30% coinsurance
Outpatient Deductible plus 30% coinsurance Deductible plus 30% coinsurance
Hospitalization
Pharmacy benefits — Blue Rx EssentialsSM
Preventive Free Free Free Free
Tier 1 Deductible$30 $35  $15
Tier 2 $60 $70 Deductible plus 30% coinsurance
Tier 3 $150 $140
Biosimilar and generic specialty $135 $170
Specialty preferred $150 $200
Specialty non-preferred $500 $500
Other benefits
Qualifies for health savings account (HSA) Yes No No No
Medicare Part D Creditable Coverage Yes Yes Yes No
myBlue HDHPSM Silver
Medical deductible — annual amount you pay before Wellmark pays
Single $5,000
Family $10,000
Coinsurance — portion of medical cost you pay after your deductible is met 0%
Out-of-pocket maximum (OPM) — the most you'll spend in a year
Single $5,000
Family $10,000
Medical benefits
Preventive care screenings Free
Virtual visits Deductible
Primary care office services
Non-primary care office services
Emergency room visit
Outpatient
Hospitalization
Pharmacy benefits — Blue Rx EssentialsSM
Preventive Free
Tier 1 Deductible
Tier 2
Tier 3
Biosimilar and generic specialty
Specialty preferred
Specialty non-preferred
Other benefits
Qualifies for health savings account (HSA) Yes
Medicare Part D Creditable Coverage Yes
CompleteBlueSM 4000
Medical deductible — annual amount you pay before Wellmark pays
Single $4,000
Family $8,000
Coinsurance — portion of medical cost you pay after your deductible is met 30%
Out-of-pocket maximum (OPM) — the most you'll spend in a year
Single $9,000
Family $18,000
Medical benefits
Preventive care screenings Free
Virtual visits $0
Primary care office services $40
Non-primary care office services $100
Emergency room visit $700
Outpatient Deductible plus 30% coinsurance
Hospitalization
Pharmacy benefits — Blue Rx EssentialsSM
Preventive Free
Tier 1 $30
Tier 2 $60
Tier 3 $150
Biosimilar and generic specialty $135
Specialty preferred $150
Specialty non-preferred $500
Other benefits
Qualifies for health savings account (HSA) No
Medicare Part D Creditable Coverage Yes
CompleteBlueSM 5000
Medical deductible — annual amount you pay before Wellmark pays
Single $5,000
Family $10,000
Coinsurance — portion of medical cost you pay after your deductible is met 30%
Out-of-pocket maximum (OPM) — the most you'll spend in a year
Single $9,000
Family $18,000
Medical benefits
Preventive care screenings Free
Virtual visits $0
Primary care office services $50
Non-primary care office services $100
Emergency room visit $600
Outpatient Deductible plus 30% coinsurance
Hospitalization
Pharmacy benefits — Blue Rx EssentialsSM
Preventive Free
Tier 1 $35 
Tier 2 $70
Tier 3 $140
Biosimilar and generic specialty $170
Specialty preferred $200
Specialty non-preferred $500
Other benefits
Qualifies for health savings account (HSA) No
Medicare Part D Creditable Coverage Yes
CompleteBlueSM Primary
Medical deductible — annual amount you pay before Wellmark pays
Single $5,800
Family $11,600
Coinsurance — portion of medical cost you pay after your deductible is met 30%
Out-of-pocket maximum (OPM) — the most you'll spend in a year
Single $8,900
Family $17,800
Medical benefits
Preventive care screenings Free
Virtual visits $0
Primary care office services $15
Non-primary care office services $100
Emergency room visit Deductible plus 30% coinsurance
Outpatient
Hospitalization
Pharmacy benefits — Blue Rx EssentialsSM
Preventive Free
Tier 1 $15
Tier 2 Deductible plus 30% coinsurance
Tier 3
Biosimilar and generic specialty
Specialty preferred
Specialty non-preferred
Other benefits
Qualifies for health savings account (HSA)
Medicare Part D Creditable Coverage No

Virtual Visits with Doctor On Demand®

Reduce absenteeism and costs while increasing employee satisfaction with virtual visits, included in all our plans. Offered at a lower cost than an office visit, Doctor On Demand allows employees to connect face-to-face with a board-certified doctor or mental health professional from virtually anywhere.

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