Blue Precision Gold HMO 207

Individual Health Insurance (Obamacare)

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Blue Precision Gold HMO 207

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Monthly Cost



Benefits & Coverage

Plan Name
Blue Precision Gold HMO 207
Plan Year
Insurance Type
Individual Health Insurance (Obamacare)
Metal Level
Out-of-Pocket Maximum
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness
$20 Copay
Specialist Visit
$40 Copay
Laboratory Outpatient and Professional Services
Not Applicable
X-rays and Diagnostic Imaging
Not Applicable
Diagnostic Imaging such as MRIs, CT, and PET scans
$250 Copay
Deductible - Family
$1500 per group
Out-of-Pocket Maximum - Family
$14700 per group

Prescription drug coverage

Generic Drugs
10.00% Coinsurance after deductible
Preferred Brand Drugs
20.00% Coinsurance after deductible
Non-Preferred Brand Drugs
30.00% Coinsurance after deductible
Specialty Drugs
40.00% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URL
Does this plan have access to a national provider network?
Is a referral required to see a Specialist?
Yes - Referrals are required for some services. Please check with your Medical Group for details.
Does this plan cover services outside plan service area?
Yes - Coverage outside our service area is available for Emergency and Urgent Care services only.
Does this plan cover services outside the country?
Yes - This plan does not cover any services and/or supplies provided to a member outside of the United States, if the member traveled to the location for the purposes of receiving medical services, supplies, or drugs.

Hospital services

Emergency Room Services
$1000 Copay with deductible, 30.00% Coinsurance after deductible. See plan brochure for when Copay is applicable.
Inpatient Hospital Services (e.g., Hospital Stay)
$750 Copay per Day
Inpatient Physician and Surgical Services
30.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service
30.00% Coinsurance after deductible


Prenatal and Postnatal Care
$20 Copay
Delivery and all inpatient services for maternity care
$750 Copay

Mental Health

Mental/Behavioral Health Outpatient Services
$20 Copay
Mental/Behavioral Health Inpatient Services
$750 Copay per Day
Substance use disorder outpatient services
$20 Copay
Substance use disorder inpatient services
$750 Copay per Day

Medical Management Programs

Does this plan offer disease managment programs?
Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy
Does this plan offer a wellness program?
Not Covered

Vision Coverage

Routine Eye Exam for Children
Eye Glasses for Children
Routine Eye Exam for Adults

Child Dental Coverage

Child Dental Coverage - Routine Dental Care
Not Covered
Child Dental Coverage - Basic Dental Care
Not Covered
Child Dental Coverage - Orthodontia
Not Covered
Child Dental Coverage - Major Dental Care
Not Covered

Adult Dental Coverage

Adult Dental Coverage - Routine Dental Care
Not Covered
Adult Dental Coverage - Basic Dental Care
Not Covered
Adult Dental Coverage - Orthodontia
Not Covered
Adult Dental Coverage - Major Dental Care
Not Covered

Exclusions and Limitations

More Included Benefits
Other Practitioner Office Visit (Nurse, Physician Assistant)
Preventive Care/Screening/Immunization
Skilled Nursing Facility
Bariatric Surgery
Cosmetic Surgery
Private-Duty Nursing
Imaging (CT/PET Scans, MRIs)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Home Health Care Services
Outpatient Rehabilitation Services
Habilitation Services
Durable Medical Equipment
Hospice Services
Routine Foot Care
Accidental Dental
Allergy Testing
Diabetes Education
Infusion Therapy
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Reconstructive Surgery
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Prescription Drugs Other
More Limited Benefits
Hearing Aids
Infertility Treatment
Chiropractic Care
More Excluded Benefits
Long-Term/Custodial Nursing Home Care
Weight Loss Programs
Dental Check-Up for Children
Abortion for Which Public Funding is Prohibited

What To Know

  • This is an ACA (Obamacare) compliant health plan.

Physician Directory

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Gold plan frequently asked questions (FAQ)

  • What is the Gold Plan?

    ObamaCare’s Gold Plan is a type of Metal Plan on the Health Insurance Marketplace. Gold Plans qualify for Tax Credits, have high premiums, and good cost sharing. Gold plans mean higher premiums, less Tax Credits, but much better cost sharing on average than Silver or Bronze.

  • How are Gold Plans different than other Obamacare health plans?

    The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Gold Plan typically pays 80% of covered medical costs.

  • How much does a Gold Plan cost?

    The monthly premium for a Gold Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and your geographic region. You can use HealthPocket’s comparison tool to compare Gold Plan premiums in your area.

  • When Can I Enroll in a Gold Plan?

    The Open Enrollment period for the 2018 Affordable Care Act health plans begins November 1, 2017 and ends December 15, 2017. See our Open Enrollment article for more information.

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