Blue Preferred Gold PPO℠ 204
Gold · PPO · Blue Cross and Blue Shield of Montana · Montana
At age 40 it costs $836.32 a month before any subsidy.
What CMS publishes about it
| Plan ID | 30751MT0550043 |
|---|---|
| Insurer | Blue Cross and Blue Shield of Montana |
| Metal level | Gold |
| Plan type | PPO |
| Deductible (individual) | $1,500 |
| Deductible (family) | $3,000 |
| Drug deductible | $0 |
| Most you could pay in a year | $9,950 |
| Family maximum | $19,900 |
| Primary care visit | $20 |
| Specialist visit | 30% Coinsurance after deductible |
| Emergency room | 30% Coinsurance after deductible |
| Inpatient stay | 30% Coinsurance after deductible |
| Generic drugs | $5 |
| Preferred brand drugs | $50 |
| Specialty drugs | $250 |
| Adult dental included | No |
| Child dental included | No |
| Share of premium buying essential health benefits | 100.00% |
| Network directory | Who is in network |
| Summary of benefits | Summary of benefits and coverage |
| Drug list | Formulary |
| Customer service | 1-855-258-8471 · TTY 1-855-258-8471 |
Where it is sold, and what it costs there
10 counties. The premium is the price before any tax credit; what you pay depends on your income.
| County | At 21 | At 30 | At 40 | At 50 | At 60 |
|---|---|---|---|---|---|
| Broadwater County | $654.40 | $742.74 | $836.32 | $1,168.76 | $1,776.04 |
| Cascade County | $654.40 | $742.74 | $836.32 | $1,168.76 | $1,776.04 |
| Chouteau County | $654.40 | $742.74 | $836.32 | $1,168.76 | $1,776.04 |
| Deer Lodge County | $654.40 | $742.74 | $836.32 | $1,168.76 | $1,776.04 |
| Gallatin County | $654.40 | $742.74 | $836.32 | $1,168.76 | $1,776.04 |
| Jefferson County | $654.40 | $742.74 | $836.32 | $1,168.76 | $1,776.04 |
| Judith Basin County | $654.40 | $742.74 | $836.32 | $1,168.76 | $1,776.04 |
| Lewis and Clark County | $654.40 | $742.74 | $836.32 | $1,168.76 | $1,776.04 |
| Silver Bow County | $654.40 | $742.74 | $836.32 | $1,168.76 | $1,776.04 |
| Teton County | $654.40 | $742.74 | $836.32 | $1,168.76 | $1,776.04 |
Open enrollment for 2026 coverage runs 1 November 2025 to 15 January 2026 in most states. Outside that window you need a qualifying life event — losing other coverage, moving, marrying, having a child — to enrol.
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Premiums, deductibles, out-of-pocket maximums and cost sharing are reproduced from the HealthCare.gov Qualified Health Plan landscape file published by the Centers for Medicare & Medicaid Services for plan year 2026. Nothing on this page is calculated by us. This is not a complete list of your options and it is not advice: to see every plan and to enrol, use HealthCare.gov or call 1-800-318-2596.