SilverPPO

Blue Advantage Silver PPO℠ 204

Blue Cross and Blue Shield of Oklahoma

Starting at

$981

/month before subsidy

Key facts

Blue Advantage Silver PPO℠ 204 is a 2026 Silver PPO health insurance plan from Blue Cross and Blue Shield of Oklahoma, sold on the ACA Marketplace in Oklahoma under plan ID 87571OK0350089. The monthly premium starts at $981 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $1,025 ($2,050 for a family), and the individual out-of-pocket maximum is $10,150 ($20,300 for a family). After the deductible, coinsurance is 50% for covered in-network care. The plan is not HSA-eligible.

Plan ID
87571OK0350089
Plan year
2026
State
Oklahoma
Metal level
Silver
Plan type
PPO
HSA-eligible
No

Individual Deductible

$1,025

Family: $2,050

Out-of-Pocket Max

$10,150

Family: $20,300

Coinsurance

50%

You pay after deductible

Network Type

PPO

OKN008

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

Medical Services

Primary Care Visit$35.00
Specialist Visit50.00% Coinsurance after deductible
Urgent Care50.00% Coinsurance after deductible
Emergency Room$950.00 Copay with deductible

Prescription Drugs

Generic Drugs20.00% Coinsurance after deductible
Brand Name Drugs35.00% Coinsurance after deductible
Specialty Drugs45.00% Coinsurance 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

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

$6,860

your estimated cost

Deductible
$1,000
Copays
$400
Coinsurance
$5,400

Managing type 2 diabetes

A year of routine care

$2,020

your estimated cost

Deductible
$1,000
Copays
$700
Coinsurance
$300

A simple fracture

ER visit + follow-up

$2,100

your estimated cost

Deductible
$1,000
Copays
$400
Coinsurance
$700
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 and Blue Shield of Oklahoma. 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

$1,827/month

Annual Premium

$11,772

OOP Maximum

$10,150

💡 What this means:

With a $1,025 deductible, you pay 100% of costs until you've spent that much. After that, you pay 50% (coinsurance) until you hit $10,150 total. Then insurance covers everything else for the year.

More plans from Blue Cross and Blue Shield of Oklahoma in Oklahoma

View all Marketplace plans in Oklahoma

Frequently asked questions about Blue Advantage Silver PPO℠ 204

How much does Blue Advantage Silver PPO℠ 204 cost per month?

Blue Advantage Silver PPO℠ 204 from Blue Cross and Blue Shield of Oklahoma starts at $981 per month before any subsidy in Oklahoma. 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 Blue Advantage Silver PPO℠ 204?

The individual medical deductible is $1,025, and the family deductible is $2,050. 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 Blue Advantage Silver PPO℠ 204?

The most you would pay in a year for covered in-network care is $10,150 for an individual and $20,300 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is Blue Advantage Silver PPO℠ 204 HSA-eligible?

No. Blue Advantage Silver PPO℠ 204 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 Blue Advantage Silver PPO℠ 204 use?

Blue Advantage Silver PPO℠ 204 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.