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Review the new plan year Summaries of Benefits and Coverage (SBC)

FY23 Plan Contracts & SBC’s

PPO FY23 Plan Contract & SBC

Traditional FY23 Plan Contract & SBC

High Deductible FY23 Plan Contract & Single SBC ; Family SBC

FY23 Medical Plan Comparison & Plan Contracts

Feature NamePPO In-NetworkPPO Out-of-NetworkTraditionalHigh Deductible
FY23 Plan ContractsActive PPOActive PPOActive TraditionalActive HDHP
FY23 Plan SummaryActive PPO SBCActive PPO SBCActive Trad SBCActive Single HDHP SBC
Active Family HDHP SBC
Deductible - Individual$350$600$450$2000
Deductible - Family$950$1,700$1,250$4,000
Out-of-Pocket Limit - Individual$3,250$6,500$4,300$5,000
Out-of-Pocket Limit -Family$6,750$13,500$8,600$10,000
Plan Payment (% of allowable charges after deductible)ChoiceDocs $0 copay, $20 Specialist copay / 85%
Non-ChoiceDocs $20 copay, $40 Specialist copay / 85%
Wellness/Preventive CareNo copay for listed services70%100%100%
Telehealth/MDLiveNo copay
(Covered 100% during the Federal State of Emergency)
N/ANo copay
(Covered 100% during the Federal State of Emergency)
100% after deductible
(Covered 100% during the Federal State of Emergency)
For details about premiums, please see Premium Rates.

PPO Highlights

  • You save money when you use In-Network Blue Cross of Idaho providers
  • Most employees choose this plan

High Deductible (HDHP) Highlights

  • HSA compatible. All services and prescriptions that are not preventive in nature are subject to the deductible before the plan begins to pay.
Please keep in mind that deductibles and benefit payments are based on allowable charges.
Details about the medical plans, exclusions and waiting periods, can be found in each medical plan document and Summary of Benefits & Coverage (SBC).

You now have access to virtual care, anywhere

Meet Sophie, your MDLive Personal Health Assistant. Sophie makes creating an account quick and easy using your smartphone, anytime, anywhere.


Text ‘bcidaho’ to MDLIVE (635483)

How it works:

Check mark icon 1. Activate your account

nurse icon 2. Choose a doctor

ThumbsUp Icon 3. Resolve your issue


I’m traveling out of the country, what should I know?

As an enrolled member in the State’s health plan, you have the ability to take your healthcare benefits with you when you go abroad. Through the Blue Cross Blue Shield Global Core program, you have access to doctors, hospitals, support tools, and resources around the world.

Here is what you need to know:

  • Always carry your insurance card.
  • Contact the plan before you travel for questions about using services.
  • If direct payment has not been arranged or your local plan is unable to verify your benefit coverage at time of service, you may need to pay upfront and submit a claim for reimbursement.

To learn more, review these resources available from the Global Core program:

Global Core Flyer
Global Core Brochure











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