Montana health plan · 2026

Blue Focus Gold POS℠ 207 · 30751MT0670001

Blue Cross Blue Shield of Montana offers this marketplace health insurance plan (Plan ID 30751MT0670001) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.

Metal level: Gold Plan type: POS CSR: Standard Gold On Exchange Plan Issuer: Blue Cross Blue Shield of Montana
Telehealth Data pending HSA eligible No Dental Not listed Vision Child
Pay / Manage Plan View issuer site

CMS AV Calculator output: 78.78% (21.22% member share on average). Learn about AV methodology.

2026 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 02 Dec 2025 06:13 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.

Monthly premium

$339 – $1328

Before subsidies

Estimate after subsidies

Deductible

$250

$500 per group

See deductible details

Max out-of-pocket

$8,900

$17800 per group

Review MOOP rules

Office visits

Primary care 20.00% Coinsurance after deductible
Specialist 40.00% Coinsurance after deductible
HSA Not eligible

Drug tiers

Generic 10.00% Coinsurance after deductible
Preferred brand 30.00% Coinsurance after deductible

View formulary tiers

$464 / mo before subsidies

≈ $5568 per year before tax credits.

Start with this unsubsidized premium, then apply marketplace tax credits to see your final monthly payment.

  • Ideal for shoppers comparing Bronze vs. Silver budgets.
  • Update your Marketplace application to apply premium tax credits.

$1470 / mo before subsidies

≈ $17643 per year before tax credits.

Pre-subsidy rate for a couple with one dependent. Switch to Silver CSR plans if you qualify to reduce these numbers.

  • Compares well against PPO vs HMO networks when planning for childcare and telehealth needs.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$1781 / mo before subsidies

≈ $21367 per year before tax credits.

Pairs with cost-sharing reductions (CSR) when you select a Silver tier and qualify based on income.

  • Use this estimate before adding childcare, dental, or vision extras.
  • CSR Silver variants can lower deductibles dramatically for eligible incomes.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$1132 / mo before subsidies

≈ $13579 per year before tax credits.

Shows the combined pre-subsidy rate for two adults. Add dependents or subsidies in your application to refine it.

  • Great for households deciding between PPO and HMO networks.
  • Telehealth and HSA perks (when offered) apply to both members.
Issuer profile See benefits

Preventive Care/Screening/Immunization

No Charge

Emergency Room Services

40.00% Coinsurance after deductible

Durable Medical Equipment

40.00% Coinsurance after deductible

Advertisement

Enrollment guidance

Stay on top of 2026 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2026 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Montana). Submit changes before the deadline to avoid a coverage gap.

  • Enroll by Dec 15 for Jan 1 starts.
  • Finalize plan switches before the window closes.

Special Enrollment Periods

You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).

  • Report the event within 60 days.
  • Keep documentation handy for Healthcare.gov or your state exchange.

CSR & subsidy reminders

Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.

  • Enter accurate income to maximize Advanced Premium Tax Credits.
  • Standard Gold On Exchange Plan plans like this one keep deductibles and copays lower if you qualify.

Thinking about switching?

Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.

  • Match provider networks so ongoing care isn’t disrupted.
  • Confirm prescriptions stay on-formulary or budget for tier changes.

Top covered benefits

How this plan handles key care scenarios

Preventive Care/Screening/Immunization

No Charge

Emergency Room Services

40.00% Coinsurance after deductible

Durable Medical Equipment

40.00% Coinsurance after deductible

Premium snapshot

Plan identifiers & filings

Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.

Plan ID 30751MT0670001
Coverage year 2026
State Montana
Issuer Blue Cross Blue Shield of Montana
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 30751MT0670001-01
Available variants

Standard Off Exchange Plan · 30751MT0670001-00

Standard On Exchange Plan · 30751MT0670001-01

Open to Indians below 300% FPL · 30751MT0670001-02

Open to Indians above 300% FPL · 30751MT0670001-03
Last plan update Wed, 15 Oct 2025 00:00 GMT
Last HealthPorta import Tue, 02 Dec 2025 06:13 GMT

Network stats

Provider access snapshot

Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).

All providers in Montana 4704
PCPs in Montana 439
Telehealth support Data pending
Nationwide providers 259485
4,704 doctors statewide 439 PCPs 25 OB/GYN

Provider network(s)

Providers Montana All US states
All 4704 259485
PCP 439 975
Allergy N/A 3
OB/GYN 25 44
Dentists 240 99351

Drug coverage overview

3,942 drugs tracked

Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.

Tier Covered drugs
NON-PREFERRED-GENERIC 2,303
NON-PREFERRED-SPECIALTY 900
NON-PREFERRED-BRAND 739
Prior authorization Drugs
Required 946
Not Required 2,996
Step therapy Drugs
Required 28
Not Required 3,914
Quantity limits Drugs
Has Limit 1,667
No Limit 2,275

Customer highlights

What stands out for members

  • Issuer: Blue Cross Blue Shield of Montana · Plan ID 30751MT0670001 · 2026 filing.
  • Disease management programs available: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 30751MT0670001-01 (Standard On Exchange Plan) currently displayed.
Advertisement

Benefits

Covered services & limitations

Everyday care

Office visits, preventive care, labs, imaging, and home health.

Chiropractic Care

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Limit: 10.0 Visit(s) per Benefit Period

Diabetes Education

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

First $250 at 100% of allowable fee, then deductible, copayment, or coinsurance apply.

Home Health Care Services

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Limit: 180.0 Visit(s) per Benefit Period

Laboratory Outpatient and Professional Services

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Other Practitioner Office Visit (Nurse, Physician Assistant)

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Preventive Care/Screening/Immunization

No Charge
Tier 1 in-network No Charge
Out-of-network 50.00% Coinsurance after deductible

Primary Care Visit to Treat an Injury or Illness

20.00% Coinsurance after deductible
Tier 1 in-network 20.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

When services are provided via telehealth, cost shares may vary. Please see benefit booklet for details.

Rehabilitative Occupational and Rehabilitative Physical Therapy

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Rehabilitative Speech Therapy

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Specialist Visit

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Urgent Care Centers or Facilities

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 40.00% Coinsurance after deductible

X-rays and Diagnostic Imaging

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Chemotherapy

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Delivery and All Inpatient Services for Maternity Care

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network $2000.00 Copay with deductible, 50.00% Coinsurance after deductible

Childbirth/delivery professional services are subject to your Medical EHB Deductible/Maximum Out of Pocket for Medical EHB benefits, if applicable.

Dialysis

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Durable Medical Equipment

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Emergency Room Services

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 40.00% Coinsurance after deductible

Emergency Transportation/Ambulance

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 40.00% Coinsurance after deductible

Emergency Transportation/Ambulance is covered when your condition is such that an ambulance is necessary. Benefits will not be provided for long distance trips or for use of an ambulance because it is more convenient than other transportation when rendered in connection with a covered Inpatient admission or covered Emergency Accident Care or covered Emergency Medical Care or if it does not meet the definition of Medically Necessary for non-emergency medical situations. Benefits will not be provided for long distance trips. See benefit book for details.

Hospice Services

No Charge
Tier 1 in-network No Charge
Out-of-network 50.00% Coinsurance after deductible

Inpatient Hospital Services (e.g., Hospital Stay)

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network $2000.00 Copay per Stay with deductible, 50.00% Coinsurance after deductible

Inpatient Physician and Surgical Services

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Mental/Behavioral Health Inpatient Services

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network $2000.00 Copay per Stay with deductible, 50.00% Coinsurance after deductible

Mental/Behavioral Health Outpatient Services

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Member cost share may increase when using a setting other than office. When services are provided via telehealth or in an outpatient facility setting , cost shares may vary. Please see benefit booklet for details.

Outpatient Facility Fee (e.g., Ambulatory Surgery Center)

$600.00 Copay with deductible, 40.00% Coinsurance after deductible
Tier 1 in-network $600.00 Copay with deductible, 40.00% Coinsurance after deductible
Out-of-network $2000.00 Copay with deductible, 50.00% Coinsurance after deductible

Member will be responsible for copay per outpatient surgery admission before and after meeting the plan deductible. The remainder of the eligible charge will be subject to plan deductible and coinsurance. See benefit book for details.

Outpatient Rehabilitation Services

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Outpatient Surgery Physician/Surgical Services

$200.00 Copay with deductible, 40.00% Coinsurance after deductible
Tier 1 in-network $200.00 Copay with deductible, 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Member will be responsible for copay per outpatient surgery service before and after meeting the plan deductible. The remainder of the eligible charge will be subject to plan deductible and coinsurance. See benefit book for details.

Radiation

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Skilled Nursing Facility

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Limit: 60.0 Days per Benefit Period

Substance Abuse Disorder Inpatient Services

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network $2000.00 Copay per Stay with deductible, 50.00% Coinsurance after deductible

Substance Abuse Disorder Outpatient Services

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Member cost share may increase when using a setting other than office. When services are provided via telehealth or in an outpatient facility setting , cost shares may vary. Please see benefit booklet for details.

Transplant

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Pregnancy & family

Maternity, newborn, pediatric dental and vision extras.

Basic Dental Care - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Hearing Aids

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Limit: 1.0 Item(s) per 3 Years

1 hearing device every 3 years for dependents age 18 & younger. Medically Necessary cochlear implants may be covered per Medical Policy.

Major Dental Care - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Prenatal and Postnatal Care

20.00% Coinsurance after deductible
Tier 1 in-network 20.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

First prenatal visit is subject to the Office Visit charge. All subsequent prenatal care is covered under delivery for maternity care.

Routine Eye Exam for Children

No Charge
Tier 1 in-network No Charge
Out-of-network No Charge

Limit: 1.0 Visit(s) per Benefit Period

Well Baby Visits and Care

No Charge
Tier 1 in-network No Charge
Out-of-network 50.00% Coinsurance after deductible

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

10.00% Coinsurance after deductible
Tier 1 in-network 10.00% Coinsurance after deductible
Tier 2 in-network 20.00% Coinsurance after deductible
Out-of-network 20.00% Coinsurance after deductible

Certain generic drugs may have a higher cost share amount than is listed on this page. When prescription drugs are bought from an out of network pharmacy additional charges may apply. See benefit book for details.

Exclusions: Coverage for certain agents or medication categories may also be excluded. These include, but are not limited to: Weight Loss, Sexual Dysfunction, OTC Equivalents, Fertility and Compounds. Any drug not found on the drug list is not covered. See benefit book for further details.

Non-Preferred Brand Drugs

35.00% Coinsurance after deductible
Tier 1 in-network 35.00% Coinsurance after deductible
Tier 2 in-network 40.00% Coinsurance after deductible
Out-of-network 40.00% Coinsurance after deductible

When prescription drugs are bought from an out of network pharmacy additional charges may apply. You may be responsible for paying the difference between the cost of a brand name drug and generic drug, if a generic was also available. See benefit book for details.

Exclusions: Coverage for certain agents or medication categories may also be excluded. These include, but are not limited to: Weight Loss, Sexual Dysfunction, OTC Equivalents, Fertility and Compounds. Any drug not found on the drug list is not covered. See benefit book for further details.

Preferred Brand Drugs

30.00% Coinsurance after deductible
Tier 1 in-network 30.00% Coinsurance after deductible
Tier 2 in-network 35.00% Coinsurance after deductible
Out-of-network 35.00% Coinsurance after deductible

When prescription drugs are bought from an out of network pharmacy additional charges may apply. You may be responsible for paying the difference between the cost of a brand name drug and generic drug, if a generic was also available. See benefit book for details.

Exclusions: Coverage for certain agents or medication categories may also be excluded. These include, but are not limited to: Weight Loss, Sexual Dysfunction, OTC Equivalents, Fertility and Compounds. Any drug not found on the drug list is not covered. See benefit book for further details.

Specialty Drugs

45.00% Coinsurance after deductible
Tier 1 in-network 45.00% Coinsurance after deductible
Tier 2 in-network 45.00% Coinsurance after deductible
Out-of-network 45.00% Coinsurance after deductible

Certain specialty drugs may have a higher cost share amount than is listed on this page. If prescription drugs are bought from an out of network pharmacy additional charges may apply. You may be responsible for paying the difference between the cost of a brand name drug and generic drug, if a generic was also available. See benefit book for details.

Exclusions: Coverage for certain agents or medication categories may also be excluded. These include, but are not limited to: Weight Loss, Sexual Dysfunction, OTC Equivalents, Fertility and Compounds. Any drug not found on the drug list is not covered. See benefit book for further details.

Wellness & extras

Vision, dental, therapies, prosthetics, weight management.

Accidental Dental

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Basic Dental Care - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Dental Check-Up for Children

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Infusion Therapy

$100.00
Tier 1 in-network $100.00
Out-of-network 50.00% Coinsurance after deductible

Member cost share may increase when using a Hospital-based facility for these services. See benefit booklet for details.

Major Dental Care - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Nutritional Counseling

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Also covered under preventive health care.

Orthodontia - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Orthodontia - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Prosthetic Devices

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Routine Dental Services (Adult)

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Weight Loss Programs

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Additional benefits

Other plan-specific services and limitations.

Abortion for Which Public Funding is Prohibited

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Acupuncture

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Limit: 12.0 Visit(s) per Benefit Period

Member cost share may increase when using a setting other than office. Please see Member Booklet for details.

Allergy Testing

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

When services are provided in an office setting, cost shares may vary. Please see benefit booklet for details.

Bariatric Surgery

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Cosmetic Surgery

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Only covered when medically necessary.

Eye Glasses for Children

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Limit: 1.0 Item(s) per Benefit Period

One pair of glasses (frames and lenses) or one pair of contacts per Benefit Period.

Habilitation Services

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Imaging (CT/PET Scans, MRIs)

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Infertility Treatment

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Covered for the diagnosis of infertility and artificial insemination.

Exclusions: Excludes invitro and prescription drugs for the treatment of infertility.

Long-Term/Custodial Nursing Home Care

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Private-Duty Nursing

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Reconstructive Surgery

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Routine Eye Exam (Adult)

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Routine Foot Care

40.00% Coinsurance after deductible
Tier 1 in-network 40.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Covered when medically necessary.

Treatment for Temporomandibular Joint Disorders

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Variant attributes

Blue Focus Gold POS℠ 207 · Variant 30751MT0670001-01

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2026

CSR Variation Type

Standard Gold On Exchange Plan

HIOS Product ID

30751MT067

Metal Level

Gold

Plan ID (Standard Component ID with Variant)

30751MT0670001-01

Plan Marketing Name

Blue Focus Gold POS℠ 207

Plan Variant Marketing Name

Blue Focus Gold POS℠ 207

Issuer & service area

Issuer-provided metadata for this variant.

Issuer ID

30751

Issuer Marketplace Marketing Name

Blue Cross and Blue Shield of Montana

Market Coverage

Individual

Multiple In Network Tiers

Yes

National Network

No

Network ID

MTN008

Out of Country Coverage

Yes

Out of Country Coverage Description

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.

Out of Service Area Coverage

Yes

Out of Service Area Coverage Description

Emergency and Urgent Care services. Non-emergency services received outside the service area may be covered with an approved waiver from the Plan.

Service Area ID

MTS018

State Code

MT

URL for Summary of Benefits & Coverage

Open link

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

AV Calculator Output Number

0.7878238237097651

Begin Primary Care Deductible Coinsurance After Number Of Copays

0

Inpatient Copayment Maximum Days

0

Medical Drug Deductibles Integrated

Yes

Medical Drug Maximum Out of Pocket Integrated

Yes

SBC Scenario, Having a Baby, Coinsurance

$4,900

SBC Scenario, Having a Baby, Copayment

$0

SBC Scenario, Having a Baby, Deductible

$250

SBC Scenario, Having Diabetes, Coinsurance

$600

SBC Scenario, Having Diabetes, Copayment

$300

SBC Scenario, Having Diabetes, Deductible

$250

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$1,000

SBC Scenario, Treatment of a Simple Fracture, Copayment

$0

SBC Scenario, Treatment of a Simple Fracture, Deductible

$250

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group

per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person

per person not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual

Not Applicable

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance

40.00%

Combined Medical and Drug EHB Deductible, In Network (Tier 2), Default Coinsurance

40.00%

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group

$17800 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person

$8900 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual

$8,900

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Family Per Group

$17800 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Family Per Person

$8900 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Individual

$8,900

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group

$71200 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person

$35600 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual

$35,600

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

MTF011

Formulary URL

Open link

Plan Brochure

Open link

SBC Scenario, Having a Baby, Limit

$60

SBC Scenario, Having Diabetes, Limit

$20

SBC Scenario, Treatment of a Simple Fracture, Limit

$0

URL for Enrollment Payment

Open link

Additional attributes

Issuer-provided metadata for this variant.

Begin Primary Care Cost-Sharing After Number Of Visits

0

Child-Only Offering

Allows Adult and Child-Only

Composite Rating Offered

No

Dental Only Plan

No

Design Type

Not Applicable

Disease Management Programs Offered

Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy

EHB Percent of Total Premium

1

First Tier Utilization

85%

Import Date

10/15/2025

Limited Cost Sharing Plan Variation - Estimated Advanced Payment

$0.00

HSA Eligible

No

New/Existing Plan

Existing

Notice Required for Pregnancy

No

Is a Referral Required for Specialist?

No

Plan Effective Date

1/1/2026

Plan Expiration Date

12/31/2026

Plan Type

POS

QHP/Non QHP

Both

Second Tier Utilization

15%

Source Name

SERFF

Plan ID

30751MT0670001

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group

per group not applicable

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person

per person not applicable

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual

Not Applicable

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group

$500 per group

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person

$250 per person

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual

$250

Combined Medical and Drug EHB Deductible, In Network (Tier 2), Family Per Group

$500 per group

Combined Medical and Drug EHB Deductible, In Network (Tier 2), Family Per Person

$250 per person

Combined Medical and Drug EHB Deductible, In Network (Tier 2), Individual

$250

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group

$2000 per group

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person

$1000 per person

Combined Medical and Drug EHB Deductible, Out of Network, Individual

$1,000

Unique Plan Design

No

Wellness Program Offered

No

Copay & coinsurance

Pharmacy cost sharing by tier

Drug tier Pharmacy type Copay amount Copay option Coinsurance rate Coinsurance option Mail order

Questions & answers

Frequently asked questions

How do I choose the right ACA plan in Montana?

Blue Focus Gold POS℠ 207 (30751MT0670001) is a Gold POS from Blue Cross Blue Shield of Montana in Montana for the 2026 coverage year.

Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.

Does Blue Focus Gold POS℠ 207 support telehealth or virtual urgent care?

The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.

Is Blue Focus Gold POS℠ 207 HSA-eligible and does it include dental or vision coverage?

It is not marked as HSA-eligible, so confirm with the issuer before relying on tax-advantaged savings.

Dental coverage is not listed for this plan.

Vision add-ons: Child.

Does Blue Focus Gold POS℠ 207 support mail-order prescriptions?

Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.

Which disease management programs come with Blue Focus Gold POS℠ 207?

The issuer lists disease management resources for: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy.

Is there out-of-country coverage for Blue Focus Gold POS℠ 207?

Yes, limited out-of-country coverage is available. Review the Summary of Benefits for reimbursement steps. Details: 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.

Does Blue Focus Gold POS℠ 207 cover care outside the service area?

Yes, you have limited out-of-area coverage. See the plan documents for referral and prior authorization rules. Details: Emergency and Urgent Care services. Non-emergency services received outside the service area may be covered with an approved waiver from the Plan.

Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
Issuer profile More plans
Open comparison tray

Add at least two plans to launch side-by-side comparisons.