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GoldHMO

AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits)

Blue Cross Blue Shield of Arizona

Starting at

$1230

/month before subsidy

Key facts

AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits) is a 2026 Gold HMO health insurance plan from Blue Cross Blue Shield of Arizona, sold on the ACA Marketplace in Arizona under plan ID 53901AZ1420116. The monthly premium starts at $1,230 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $4,800 ($9,600 for a family), and the individual out-of-pocket maximum is $4,800 ($9,600 for a family). After the deductible, coinsurance is 0% for covered in-network care. The plan is not HSA-eligible.

Plan ID
53901AZ1420116
Plan year
2026
State
Arizona
Metal level
Gold
Plan type
HMO
HSA-eligible
No

Individual Deductible

$4,800

Family: $9,600

Out-of-Pocket Max

$4,800

Family: $9,600

Coinsurance

0%

You pay after deductible

Network Type

HMO

AZN002

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

Medical Services

Primary Care VisitNo Charge after deductible
Specialist VisitNo Charge after deductible
Urgent CareNo Charge after deductible
Emergency RoomNo Charge after deductible

Prescription Drugs

Generic DrugsNo Charge
Brand Name DrugsNo Charge after deductible
Specialty DrugsNo Charge after deductible
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

$4,850

your estimated cost

Deductible
$4,800
Copays
$0
Coinsurance
$0

Managing type 2 diabetes

A year of routine care

$4,690

your estimated cost

Deductible
$4,500
Copays
$170
Coinsurance
$0

A simple fracture

ER visit + follow-up

$2,600

your estimated cost

Deductible
$2,590
Copays
$10
Coinsurance
$0
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 Blue Cross Blue Shield of Arizona. These are the authoritative source for coverage details.
Summary of Benefits & Coverage (SBC)Standardized cost & coverage summaryPlan BrochureFull plan details from the insurerDrug FormularyCovered prescriptions & drug tiers
Who This Plan Is Best For

This Gold HMO plan is designed for people who use healthcare frequently and want predictable costs when they visit the doctor.

Consider this plan if you:

  • Have ongoing health conditions requiring regular care
  • Take multiple prescription medications
  • Prefer lower costs at the time of service
  • Want peace of mind with comprehensive coverage

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

$1,630/month

Annual Premium

$14,760

OOP Maximum

$4,800

💡 What this means:

With a $4,800 deductible, you pay 100% of costs until you've spent that much. After that, you pay 0% (coinsurance) until you hit $4,800 total. Then insurance covers everything else for the year.

More plans from Blue Cross Blue Shield of Arizona in Arizona

View all Marketplace plans in Arizona

Frequently asked questions about AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits)

How much does AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits) cost per month?

AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits) from Blue Cross Blue Shield of Arizona starts at $1,230 per month before any subsidy in Arizona. 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 AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits)?

The individual medical deductible is $4,800, and the family deductible is $9,600. 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 AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits)?

The most you would pay in a year for covered in-network care is $4,800 for an individual and $9,600 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits) HSA-eligible?

No. AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits) 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 AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits) use?

AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits) is a HMO plan. HMO plans generally require you to use in-network providers and to get a referral to see a specialist, in exchange for lower costs.

Understand what you'd actually pay

Enroll at HealthCare.govBrowse Arizona plans

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.