SilverPPO

my Blue Access WV PPO Premier Silver 0

Highmark Blue Cross Blue Shield West Virginia

Starting at

$988

/month before subsidy

Key facts

my Blue Access WV PPO Premier Silver 0 is a 2026 Silver PPO health insurance plan from Highmark Blue Cross Blue Shield West Virginia, sold on the ACA Marketplace in West Virginia under plan ID 31274WV0590003. The monthly premium starts at $988 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $0, and the individual out-of-pocket maximum is $9,700 ($19,400 for a family). After the deductible, coinsurance is 30% for covered in-network care. The plan is not HSA-eligible.

Plan ID
31274WV0590003
Plan year
2026
State
West Virginia
Metal level
Silver
Plan type
PPO
HSA-eligible
No

Individual Deductible

$0

Family: $0

Out-of-Pocket Max

$9,700

Family: $19,400

Coinsurance

30%

You pay after deductible

Network Type

PPO

WVN001

Cost Sharing
What you pay for common services (after deductible unless noted)

Medical Services

Primary Care Visit$45.00
Specialist Visit$45.00
Urgent Care$90.00
Emergency Room$1,250.00

Prescription Drugs

Generic Drugs$5.00
Brand Name Drugs$250.00
Specialty Drugs50.00%
CMS Quality Rating
The federal government's star rating for this plan, based on clinical data and member surveys — the same rating shown on HealthCare.gov.
3.0overall
Medical care

How well doctors manage and coordinate care

Member experience
Not rated

Member-survey satisfaction with the plan

Plan administration

Customer service, billing, and access to information

What you'd typically pay
Standardized coverage examples from this plan's official Summary of Benefits & Coverage — your estimated out-of-pocket cost in three common situations (in-network).

Having a baby

Normal delivery

$3,460

your estimated cost

Deductible
$0
Copays
$3,400
Coinsurance
$0

Managing type 2 diabetes

A year of routine care

$1,320

your estimated cost

Deductible
$0
Copays
$1,100
Coinsurance
$200

A simple fracture

ER visit + follow-up

$1,100

your estimated cost

Deductible
$0
Copays
$700
Coinsurance
$400
Is your medication or doctor covered?
Check this plan against your prescriptions and providers, using live data from the federal Marketplace (CMS). Always confirm with the insurer before enrolling.
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Official Plan Documents
Published by Highmark Blue Cross Blue Shield West Virginia. These are the authoritative source for coverage details.
Who This Plan Is Best For

This Silver PPO plan offers a balanced approach between monthly premiums and out-of-pocket costs, making it a popular choice for many families.

Consider this plan if you:

  • Visit the doctor a few times per year
  • Take regular prescription medications
  • Want moderate protection against high medical bills
  • May qualify for Cost-Sharing Reductions (CSR) to lower deductibles

This summary is generated based on plan attributes for educational purposes only.

Worst-Case Monthly Cost
What you'd pay if you hit your out-of-pocket maximum

If you max out this year

$1,796/month

Annual Premium

$11,856

OOP Maximum

$9,700

💡 What this means:

With a $0 deductible, you pay 100% of costs until you've spent that much. After that, you pay 30% (coinsurance) until you hit $9,700 total. Then insurance covers everything else for the year.

More plans from Highmark Blue Cross Blue Shield West Virginia in West Virginia

View all Marketplace plans in West Virginia

Frequently asked questions about my Blue Access WV PPO Premier Silver 0

How much does my Blue Access WV PPO Premier Silver 0 cost per month?

my Blue Access WV PPO Premier Silver 0 from Highmark Blue Cross Blue Shield West Virginia starts at $988 per month before any subsidy in West Virginia. Most Marketplace enrollees qualify for a premium tax credit that lowers what they actually pay — estimate your subsidy to see your net premium.

What is the deductible for my Blue Access WV PPO Premier Silver 0?

The individual medical deductible is $0. You pay for covered care out of pocket until you meet the deductible, after which the plan shares costs with you.

What is the out-of-pocket maximum for my Blue Access WV PPO Premier Silver 0?

The most you would pay in a year for covered in-network care is $9,700 for an individual and $19,400 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is my Blue Access WV PPO Premier Silver 0 HSA-eligible?

No. my Blue Access WV PPO Premier Silver 0 is not classified as an HSA-eligible high-deductible health plan, so it cannot be paired with a Health Savings Account.

What type of network does my Blue Access WV PPO Premier Silver 0 use?

my Blue Access WV PPO Premier Silver 0 is a PPO plan. PPO plans let you see specialists without a referral and use out-of-network providers (at higher cost), offering the most flexibility.

Understand what you'd actually pay

Important Notice

Plan details and costs shown are estimates for educational purposes only. Actual costs, coverage, and availability may vary. Always verify plan details and enroll through official channels at HealthCare.gov or your state marketplace.