2018 Individual and Family Plans

Blue Cross and Blue Shield of Montana (BCBSMT) has been around for 75 years. We stand by our members as one of the most experienced health care coverage companies in the state.

View Plans and Pricing

See what Individual and Family Health Care Plans are available in your area.

If you’re currently a member and are considering a new plan, here are a few tools and tips Opens in new window for next year.

Plan Networks

Different health care plans use certain groups of doctors, hospitals and other health care professionals. These are known as networks, and each network provides a full range of covered health care services.

Networks – and member costs - differ from plan to plan. Before you choose a plan, you may want to check if your doctor or hospital is in the network. If you visit a doctor outside of your network, you may have to pay more for your care. In some cases, you may have to pay the full cost.

Blue Focus POSSM

Blue Preferred PPOSM

Plan Levels

We have three levels of health care plans available for 2018 – bronze, silver and gold. All of our plans follow the Affordable Care Act (ACA) rules and give you the same set of essential health benefits, quality and amount of care (but your out-of-pocket costs for the benefits may differ).

Bronze Plans

Lowest premium costs

Higher out-of-pocket costs when you receive care

  • We pay 60%
  • You pay 40%

Silver Plans

Higher premium costs than Bronze plans

Lower out-of-pocket costs than Bronze plans

  • We pay 70%
  • You pay 30%

Gold Plans

Higher premium costs than Silver plans

Lower out-of pocket costs than silver plans

  • We pay 80%
  • You pay 20%

The percentages shown reflect the average total cost for members, including all deductibles, copays and coinsurance. Your actual costs and ratios may vary based on your specific plan and usage.

Our plan brochure can help you get started or learn more about our plans.

Financial Assistance

When shopping for a new health care plan, you may qualify for help with the cost of buying coverage by:

  • Getting low or no-cost coverage through a government program
  • Lowering your monthly premium bill with a premium tax credit (PTC)
  • Qualifying for cost-sharing reductions (CSRs) which are discounts to lower your out-of-pocket costs, like deductibles, copayments, coinsurance and prescription costs

Shopping Assistance

Thank you for looking at coverage options from BCBSMT. We’re here to help you get the 2018 coverage – and information – you need.

Key Coverage Details

Selecting a health care plan with BCBSMT may include some of these key coverage details.

Essential Health Benefits

Every one of our health care plans cover these essential health benefit categories:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health disorder services
  • Substance use disorder services
  • Prescription drugs
  • Rehabilitative services and devices
  • Laboratory services
  • Preventive and wellness services
  • Chronic disease management
  • Pediatric services

Preventive Care Services

Many long-term illnesses can be prevented or managed when found early. With ACA, most health care plans must cover a range of preventive care services with no in-network, out-of-pocket costs. Services include certain screenings, immunizations, and other types of care, like:

  • Blood pressure, diabetes and cholesterol tests
  • Many cancer tests, such as mammograms and colonoscopies
  • Help to stop smoking, lose weight, fight depression and reduce alcohol abuse

Remember, you may have to pay more for your care if you visit a doctor outside of your network. You can find in-network doctors and hospitals using our online Provider Finder® tool.

See a full list of covered preventive services

24/7 Non-Emergency Care Options

If you’re not having a medical emergency, you have several options for care. Some are available 24 hours a day, seven days a week, like:

  1. Internet/Wi-Fi connection is needed for computer access. Data charges may apply. Check your cellular data or internet service provider’s plan for details. Non-emergency medical service in Idaho, Montana and New Mexico is limited to interactive audio/video (video only), along with the ability to prescribe. Non-emergency medical service in Arkansas is limited to interactive audio/video (video only) for initial consultation, along with the ability to prescribe. Behavioral Health service is limited to interactive audio/video (video only), along with the ability to prescribe in all states. Service availability depends on location at the time of consultation.

    Virtual Visits, Powered by MDLIVE may not be available on all plans. Virtual Visits are subject to the terms and conditions of your benefit plan, including benefits, limitations, and exclusions. MDLIVE operates subject to state regulations and may not be available in certain states. MDLIVE is not an insurance product nor a prescription fulfillment warehouse. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA-controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. MDLIVE physicians reserve the right to deny care for potential misuse of services.

    MDLIVE operates and administers the virtual visit program and is solely responsible for its operations and that of its contracted providers. MDLIVE and the MDLIVE logo are registered trademarks of MDLIVE, Inc. and may not be used without written permission.

    Blue Cross®, Blue Shield® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.

Prescription Drug Coverage

With prescription drug coverage, you may get help with paying for your medicine. Based on your coverage, you may pay either a fixed dollar amount (copayment) or a percentage (coinsurance) of your prescription drug costs. Your prescription drug coverage includes:

  • A broad pharmacy network
  • Mail order services
  • Access to online tools for managing your prescription drugs
  • A drug list
  • Other pharmacy benefits

Note: Prescription drug coverage varies by plan.

View Plans and Pricing

See what Individual and Family Health Care Plans are available in your area.