Montana health plan · 2026

Blue Preferred Silver PPO℠ 308 · 30751MT0550072

Blue Cross Blue Shield of Montana offers this marketplace health insurance plan (Plan ID 30751MT0550072) 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: Silver Plan type: PPO CSR: 73% AV Level Silver 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: 73.69% (26.31% 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

$540 – $2119

Before subsidies

Estimate after subsidies

Deductible

N/A

N/A

See deductible details

Max out-of-pocket

$6,000

$12000 per group

Review MOOP rules

Office visits

Primary care No Charge after deductible
Specialist No Charge after deductible
HSA Not eligible

Drug tiers

Generic $10.00
Preferred brand $50.00

View formulary tiers

$740 / mo before subsidies

≈ $8883 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.

$2346 / mo before subsidies

≈ $28148 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.
  • This Silver tier qualifies for CSR if household income is ≤250% FPL.

$2841 / mo before subsidies

≈ $34090 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.
  • This Silver tier qualifies for CSR if household income is ≤250% FPL.

$1805 / mo before subsidies

≈ $21664 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

No Charge after deductible

Durable Medical Equipment

No Charge after deductible

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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.
  • 73% AV Level Silver 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

No Charge after deductible

Durable Medical Equipment

No Charge 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 30751MT0550072
Coverage year 2026
State Montana
Issuer Blue Cross Blue Shield of Montana
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 30751MT0550072-04
Available variants

Standard Off Exchange Plan · 30751MT0550072-00

Standard On Exchange Plan · 30751MT0550072-01

Open to Indians below 300% FPL · 30751MT0550072-02

Open to Indians above 300% FPL · 30751MT0550072-03

73% AV Silver Plan · 30751MT0550072-04

87% AV Silver Plan · 30751MT0550072-05

94% AV Silver Plan · 30751MT0550072-06
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 706
PCPs in Montana 3
Telehealth support Data pending
Nationwide providers 254735
706 doctors statewide 3 PCPs

Provider network(s)

Providers Montana All US states
All 706 254735
PCP 3 444
Allergy N/A 3
OB/GYN N/A 11
Dentists 238 99349

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 30751MT0550072 · 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 30751MT0550072-04 (73% AV Silver Plan) currently displayed.
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Benefits

Covered services & limitations

Everyday care

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

Chiropractic Care

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

Limit: 10.0 Visit(s) per Benefit Period

Diabetes Education

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

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

Home Health Care Services

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

Limit: 180.0 Visit(s) per Benefit Period

Laboratory Outpatient and Professional Services

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

Other Practitioner Office Visit (Nurse, Physician Assistant)

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

Preventive Care/Screening/Immunization

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

Primary Care Visit to Treat an Injury or Illness

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

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

Rehabilitative Occupational and Rehabilitative Physical Therapy

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

Rehabilitative Speech Therapy

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

Specialist Visit

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

Urgent Care Centers or Facilities

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

X-rays and Diagnostic Imaging

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

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Chemotherapy

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

Delivery and All Inpatient Services for Maternity Care

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network $2000.00 Copay with deductible, No Charge after deductible

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

Dialysis

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

Durable Medical Equipment

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

Emergency Room Services

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

Emergency Transportation/Ambulance

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

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

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network $2000.00 Copay per Stay with deductible, No Charge after deductible

Inpatient Physician and Surgical Services

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

Mental/Behavioral Health Inpatient Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network $2000.00 Copay per Stay with deductible, No Charge after deductible

Mental/Behavioral Health Outpatient Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge 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)

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network $2000.00 Copay with deductible, No Charge after deductible

Outpatient Rehabilitation Services

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

Outpatient Surgery Physician/Surgical Services

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

Radiation

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

Skilled Nursing Facility

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

Limit: 60.0 Days per Benefit Period

Substance Abuse Disorder Inpatient Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network $2000.00 Copay per Stay with deductible, No Charge after deductible

Substance Abuse Disorder Outpatient Services

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

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

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

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

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

$10.00
Tier 1 in-network $10.00
Tier 2 in-network $20.00
Out-of-network $20.00

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

$100.00
Tier 1 in-network $100.00
Tier 2 in-network $150.00
Out-of-network $150.00

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

$50.00
Tier 1 in-network $50.00
Tier 2 in-network $100.00
Out-of-network $100.00

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

$250.00
Tier 1 in-network $250.00
Tier 2 in-network $250.00
Out-of-network $250.00

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

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

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

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

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

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

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

Only covered when medically necessary.

Eye Glasses for Children

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

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

Imaging (CT/PET Scans, MRIs)

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

Infertility Treatment

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

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

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge 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 Preferred Silver PPO℠ 308 · Variant 30751MT0550072-04

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2026

CSR Variation Type

73% AV Level Silver Plan

HIOS Product ID

30751MT055

Metal Level

Silver

Plan ID (Standard Component ID with Variant)

30751MT0550072-04

Plan Marketing Name

Blue Preferred Silver PPO℠ 308

Plan Variant Marketing Name

Blue Preferred Silver PPO℠ 308

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

MTN009

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

MTS039

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

0.736942252

Begin Primary Care Deductible Coinsurance After Number Of Copays

0

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

0.00%

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

0.00%

Inpatient Copayment Maximum Days

0

Medical Drug Deductibles Integrated

No

Medical Drug Maximum Out of Pocket Integrated

Yes

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

0.00%

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

0.00%

SBC Scenario, Having a Baby, Coinsurance

$0

SBC Scenario, Having a Baby, Copayment

$0

SBC Scenario, Having a Baby, Deductible

$6,000

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$500

SBC Scenario, Having Diabetes, Deductible

$1,900

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$0

SBC Scenario, Treatment of a Simple Fracture, Copayment

$10

SBC Scenario, Treatment of a Simple Fracture, Deductible

$2,800

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

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

$12000 per group

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

$6000 per person

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

$6,000

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

$12000 per group

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

$6000 per person

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

$6,000

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

$48000 per group

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

$24000 per person

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

$24,000

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

MTF014

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

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

per group not applicable

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

per person not applicable

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

Not Applicable

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

$0 per group

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

$0 per person

Drug EHB Deductible, In Network (Tier 1), Individual

$0

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

$0 per group

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

$0 per person

Drug EHB Deductible, In Network (Tier 2), Individual

$0

Drug EHB Deductible, Out of Network, Family Per Group

per group not applicable

Drug EHB Deductible, Out of Network, Family Per Person

per person not applicable

Drug EHB Deductible, Out of Network, Individual

Not Applicable

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

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

per group not applicable

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

per person not applicable

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

Not Applicable

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

$12000 per group

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

$6000 per person

Medical EHB Deductible, In Network (Tier 1), Individual

$6,000

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

$12000 per group

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

$6000 per person

Medical EHB Deductible, In Network (Tier 2), Individual

$6,000

Medical EHB Deductible, Out of Network, Family Per Group

$48000 per group

Medical EHB Deductible, Out of Network, Family Per Person

$24000 per person

Medical EHB Deductible, Out of Network, Individual

$24,000

Plan Effective Date

1/1/2026

Plan Expiration Date

12/31/2026

Plan Type

PPO

QHP/Non QHP

Both

Second Tier Utilization

15%

Source Name

SERFF

Plan ID

30751MT0550072

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 Preferred Silver PPO℠ 308 (30751MT0550072) is a Silver PPO 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 Preferred Silver PPO℠ 308 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 Preferred Silver PPO℠ 308 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 Preferred Silver PPO℠ 308 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 Preferred Silver PPO℠ 308?

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 Preferred Silver PPO℠ 308?

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 Preferred Silver PPO℠ 308 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.
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