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New special enrollment period

As of February 15 and continuing through May 15, 2021, you may be eligible to enroll for new healthcare coverage. If you live in Idaho, the state’s enrollment period begins March 1 and ends April 30. For questions about the timing and eligibility differences across Idaho, Montana, Oregon, and Washington, please contact us.

Health Plans for Individuals & Families

Plan availability varies by location. Please enter your ZIP code to see plans available in your area.

If members receive services from out-of-network providers, their deductible and out-of-pocket limit will be higher than the amounts listed in the chart below. All plans are available direct with PacificSource.

Gold 1500
Office Visits

Primary care
No deductible, $20

Urgent care
No deductible, $20

Specialist
No deductible, $40

Tier 1 prescription
Drug coverage No deductible, $15

In-network Costs 

Deductible
Individual $1,500
Family $3,000

Out-of-pocket max
Individual $5,500
Family $11,000

Preventive services
No deductible, covered in full

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Silver 3000
Office Visits

Primary care
No deductible, $35

Urgent care
No deductible, $35

Specialist
After deductible, 40%

Tier 1 prescription
Drug coverage No deductible, $15

In-network Costs 

Deductible
Individual $3,000
Family $6,000

Out-of-pocket max
Individual $8,150
Family $16,300

Preventive services
No deductible, covered in full

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Silver 4000
Office Visits

Primary care
No deductible, $20

Urgent care
No deductible, $20

Specialist
No deductible, $40

Tier 1 prescription
Drug coverage After deductible, 30%

In-network Costs 

Deductible
Individual $4,000
Family $8,000

Out-of-pocket max
Individual $7,900
Family $15,800

Preventive services
No deductible, covered in full

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Bronze 7000
Office Visits

Primary care
No deductible, $35

Urgent care
No deductible, $35

Specialist
After deductible, 40%

Tier 1 prescription
Drug coverage After deductible, 40%

In-network Costs 

Deductible
Individual $7,000
Family $14,000

Out-of-pocket max
Individual $8,550
Family $17,100

Preventive services
No deductible, covered in full

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Bronze HSA 6900
Office Visits

Primary care
After deductible, covered in full

Urgent care
After deductible, covered in full

Specialist
After deductible, covered in full

Tier 1 prescription
Drug coverage After deductible, covered in full

In-network Costs 

Deductible
Individual $6,900
Family $13,800

Out-of-pocket max
Individual $6,900
Family $13,800

Preventive services
No deductible, covered in full

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Standard Gold
Office Visits

Primary care
No deductible, $20

Urgent care
No deductible, $60

Specialist
No deductible, $40

Tier 1 prescription
Drug coverage No deductible, $10

In-network Costs 

Deductible
Individual $1,500
Family $3,000

Out-of-pocket max
Individual $7,300
Family $14,600

Preventive services
No deductible, covered in full

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Standard Silver
Office Visits

Primary care
No deductible, $40

Urgent care
No deductible, $70

Specialist
No deductible, $80

Tier 1 prescription
Drug coverage No deductible, $15

In-network Costs 

Deductible
Individual $3,650
Family $7,300

Out-of-pocket max
Individual $8,550
Family $17,100

Preventive services
No deductible, covered in full

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Standard Bronze
Office Visits

Primary care
No deductible, $50

Urgent care
No deductible, $100

Specialist
No deductible, $100

Tier 1 prescription
Drug coverage No deductible, $20

In-network Costs 

Deductible
Individual $8,550
Family $17,100

Out-of-pocket max
Individual $8,550
Family $17,100

Preventive services
No deductible, covered in full

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Catastrophic+
Office Visits

Primary care
Telemedicine and office combined visits 1-3 no deductible, After deductible, covered in full. Visits 4+ After deductible, covered in full after deductible.

Urgent care
After deductible, covered in full

Specialist
After deductible, covered in full

Tier 1 prescription
Drug coverage After deductible, covered in full

In-network Costs 

Deductible
Individual $8,550
Family $17,100

Out-of-pocket max
Individual $8,550
Family $17,100

Preventive services
No deductible, covered in full

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Dental Advantage 0-20-50 1000
Members Pay

Deductible
Individual $0
Family $0

Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50%

Annual Max. Benefit

$1,000 per person, age 19 and older

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Dental Advantage 0-20-50 1500
Members Pay

Deductible
Individual $0
Family $0

Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50%

Annual Max. Benefit

$1,500 per person, age 19 and older

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Kids Dental Advantage 0-20-50
Members Pay

Deductible
Individual $0
Family $0

Services Preventive No deductible, 0% Basic No deductible, 20% Major No deductible, 50%

Annual Max. Benefit

N/A

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Learn more about our plans and networks

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‡‡‡Deductible and out-of-pocket maximum amounts shown above are the costs for individuals. Amounts for families are twice the individual amounts.

**This is a cost-sharing plan. Cost-sharing plans are only available to those who qualify financially and enroll through HealthCare.gov.

***The Affordable Care Act (ACA) has special provisions for members of federally recognized American Indian tribes that purchase healthcare coverage through the Marketplace, including zero-cost health services for those whose income is at or below 300 percent of the Federal Poverty Level. Please note that even with a zero cost-sharing plan, out-of-network providers can bill for the amount over the network rate.

+Only available for people under 30, or people of any age with a hardship exemption or affordability exemption.