Blue Cross of Idaho

SLHP Gold CarePoint 2000

Plan Overview

Medical Deductible
  • Individual: $2,000
  • Family: $4,000
  • Per Person: $2,000
Prescription Drug Deductible
  • Individual: Included in Medical
  • Family: Included in Medical
  • Per Person: Included in Medical
Medical Out-of-Pocket Maximum
  • Individual: $5,500
  • Family: $11,000
  • Per Person: $5,500
Drug Out-of-Pocket Maximum
  • Individual: Included in Medical
  • Family: Included in Medical
  • Per Person: Included in Medical

Office Visit

Primary Doctor
  • Standard: $20 Copay
Specialist
  • Standard: $50 Copay

Prescription Drug Information

Preferred Brand Drugs
  • Standard: $30 Copay after deductible
Non Preferred Brand Drugs
  • Standard: $50 Copay after deductible
Generic Drugs
  • Standard: $10 Copay
Specialty Drugs
  • Standard: 50% Coinsurance after deductible

Inpatient Coverage

Hospital Services
  • Standard: 20% Coinsurance after deductible
Inpatient Services
  • Standard: 20% Coinsurance after deductible

Emergency and Urgent Care

Emergency Room
  • Standard: $350 Copay after deductible
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