Health Plan Options for Peace of Mind
2021 ACA Plan Comparison Guide | South Dakota Small Group Plans
HDHPs encourage employee engagement in their health care by involving them in the full cost of care until they reach their deductible — and offers the lowest monthly premiums.
High-Deductible plan options
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Amounts reflect covered, in-network services only.
Health Care Services | myBlue HDHPSM Bronze | myBlue HDHPSM Silver |
---|---|---|
Annual Benefit — Deductible 1 | ||
Single deductible | $6,900 | $4,500 |
Family2 deductible | $13,800 | $9,000 |
Coinsurance — member pays | 0% | 0% |
Annual benefit — Out-of-Pocket Maximum (opm) In-network | ||
Single out-of-pocket maximum | $6,900 | $6,750 |
Family3 out-of-pocket maximum | $13,800 | $13,500 |
Preventive care4 screenings, immunizations | Free | Free |
Virtual Visit5 | Deductible applies | $0 after deductible |
Primary care office services6 | Deductible applies | $0 after deductible |
Non-primary care office services | Deductible applies | $60 after deductible |
Emergency room | Deductible applies | $250 after deductible |
Prescription drugs - Blue Rx EssentialsSM | ||
Tier 1: Most generics and select branded drugs | Deductible applies | $20 after deductible |
Tier 2: Preferred drugs based on effectiveness | $60 after deductible | |
Tier 3: Non-preferred drugs that have cost-effective alternatives | $125 after deductible | |
Specialty preferred: Proven to treat complex and rare conditions | $150 after deductible | |
Non-preferred: More beneficial than preferred alternative | $200 after deductible | |
Medicare Part D Creditable Coverage7 | No | Yes |