Medical Plans at a Glance
2025–26 in-network Plans
Blue (Traditional) Plan | Orange (HDHP) Plan | |
---|---|---|
Preventive Care (per BCBSM Guidelines) | 100% coverage. Not subject to deductible. | 100% coverage. Not subject to deductible. |
Deductible | $1,000 per person; $2,000 family maximum | $2,000 if you have single coverage; $4,000 if you have two-person or family coverage |
Primary Care office visits | $25 copay. Not subject to deductible. | 80% coverage after deductible is met. |
online office visits | $10 copay. Not subject to deductible. | $49 fee until deductible met, then 80% coverage. |
urgent care and Specialist Office Visits | $50 copay. Not subject to deductible. | 80% coverage after deductible is met. |
Ambulance | $50 copay. Not subject to deductible. | 80% coverage after deductible is met. |
Emergency room visits | $250 copay. Not subject to deductible | 80% coverage after deductible is met. |
Most other covered services (see Benefits at a Glance below for exceptions of services covered at lower percent) | 80% coverage after deductible is met. | 80% coverage after deductible is met. |
Annual out-of-pocket maximum | $4,000 per person; $8,000 family maximum | $5,000 if you have single coverage. $9,200 if you have two-person or family coverage. |
auto accident exclusion (benefits are not payable under the plan for injuries received
in a accident involving a motor vehicle) FOR MORE INFO REVIEW: FAQ |
Yes, applicable. |
Yes, applicable. |
Benefits at a glance | Blue BAAG | Orange BAAG |
Summary of Benefits and Coverage: | Blue SOB&C | Orange SOB&C |
Employee premiums (per pay period, two times/month) *additional spouse surcharge (+$100 per pay) may apply |
Salary <$33,500K Single: $38.93 Two-Person*: $113.59 Family*: $166.59 Salary $33,500K–$70K Single: $50.81 Two-Person*: $148.79 Family*: $220.05 Salary $70K–$100K Single: $62.45 Two-Person*: $177.49 Family*: $262.28 Salary >$100K Single: $68.52 Two-Person*: $196.46 Family*: $287.42 |
Single: $16.80 Two-Person*: $41.39 Family*: $60.50 |
Provider Informaiton
1.877.671.2583
workP. 616.395.7811
hr@hope.edu