Network Options: Yukon Network
You’ve built a trusting relationship and you want to keep it. But, did you know that you can also save money by using an in-network provider? That’s why you will be able to choose a provider network that is right for you and your family’s health and wellbeing.
800-508-4722 | premera.com | Group number: 4015771
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Medical Plans |
Understanding your deductible
Your deductible is the amount you must pay for covered services before your insurance plan begins to pay for covered services. For example, if your plan has a $3,000 deductible, you’ll pay the first $3,000 for covered services. You can meet the deductible with an all-at-once charge for an expensive service — such as an MRI or surgery — or with charges from several small services — such as doctor visits — where you pay a small copay. Keep in mind that copays don’t usually count toward your deductible.
Coinsurance
Once you’ve met your deductible, you’ll pay coinsurance for covered services. Coinsurance is the percentage of costs you’re responsible for paying, which counts towards your out-of-pocket maximum.
Out-of-pocket maximum
The out-of-pocket maximum is the maximum amount that you’ll pay out of pocket in a plan year. Once you’ve paid your deductible and paid coinsurance up to the out-of-pocket maximum — all covered services will be 100% paid for by the insurance carrier for the remainder of the plan year. When considering your medical plan options, consideration for the out-of-pocket maximum is essential.
Option 1: Premera Blue Cross Blue Shield $1,000 PPO
With this plan you will have access to the Yukon Network. Please check with Premera to see if your provider is in the Yukon Network so that you can take advantage of greater discounts on care for you and your family.
Embedded Deductible and Out-of-Pocket Maximums
On this plan, both the family deductible and family out-of-pocket maximum are embedded. This means:
- Each family member has their own individual deductible and out-of-pocket maximum.
- There is also a family-level deductible and out-of-pocket maximum.
Here’s how it works:
If one person meets their individual deductible of $1,000, the plan starts paying coinsurance for that person — even if the family hasn’t reached the $2,000 family deductible yet. Similarly, once an individual hits their own $4,500 out-of-pocket maximum, their covered costs are paid at 100% — even if the family hasn’t reached the $9,000 family out-of-pocket maximum yet.
| OPTION 1: $1,000 PPO YUKON NETWORK |
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|---|---|---|
| In-Network: Preferred Providers |
In-Network: Participating Providers |
|
| Annual Deductible Jan 1 — Dec 31 Individual Maximum per Family |
You pay up to $1,000 per individual $2,000 per family |
You pay up to $1,000 per individual $2,000 per family |
| Family Deductible | Embedded | |
| Coinsurance | After the Deductible is met, you pay 20% | After the Deductible is met, you pay 40% |
| Out-of-pocket Maximum Jan 1 — Dec 31 | You pay no more than $4,500 per individual $9,000 per family |
You pay no more than $4,500 per individual $9,000 per family |
| Preventive Services | You pay $0 according to government guidelines | |
| Office Visits Primary Care Specialist |
You pay $25 copay* $60 copay* |
You pay $25 copay* $60 copay* |
| Premera Virtual Care General Medicine |
Covered in full* | |
| Diagnostic & Laboratory Services | You pay 20% AD |
You pay 40% AD |
| Mental Health Services Outpatient Inpatient |
You pay $25 copay 20% AD |
You pay $25 copay 40% AD |
| Hospital & Facility Services | You pay 20% AD |
You pay 40% AD |
| Emergency Services Freestanding Urgent Care Center Emergency Room |
You pay $40 copay* $200 copay + 20% AD |
You pay $40 copay* $200 copay + 40% AD |
| Rehab & Neuro Therapy Services Inpatient Rehab (30 days per calendar year) Outpatient Rehab (45 visits per calendar year) Inpatient Neuro Therapy Outpatient Neuro Therapy(45 days per calendar year) |
You pay 20% AD $60 copay 20% AD $60 copay |
You pay 40% AD $60 copay 40% AD $60 copay |
| Vision & Hearing Services | ||
| Routine Vision Exam One per calendar year |
You pay 10%* |
You pay 10%* |
| Vision Hardware Frames, Lenses, or Contacts |
Covered in full* up to $350, per calendar year | Covered in full* up to $350, per calendar year |
| Pediatric Vision Exam One per calendar year for children under age 19 |
You pay $25 copay* |
You pay $25 copay* |
| Pediatric Vision Hardware One pair of Glasses (Frames & Lenses) OR one 12-month supply of Contact Lenses per calendar year for children under age 19 |
You pay Covered in full* |
You pay Covered in full* |
| Routine Hearing Exam One per calendar year |
You pay 20%* |
You pay 20%* |
| Hearing Hardware One device per ear, every three years |
You pay 20%* |
You pay 20%* |
| Out-of-Network Costs | ||
| Deductible Individual Maximum per Family |
You pay $2,000 per Individual $4,000 per Family |
You pay $2,000 per Individual $4,000 per Family |
| Out-of-Network Individual Maximum per Family |
You pay $45,000 per Individual $90,000 per Family |
You pay $45,000 per Individual $90,000 per Family |
| Out-of-Network Coinsurance | After the Out-of-Network Deductible is met, you pay 60% | After the Out-of-Network Deductible is met, you pay 60% |
| AD: After Deductible
*Indicates deductible waived This information is designed to help you choose a benefit plan for 2026 only. Please refer to the Plan Documents provided by the carrier for information regarding coverage, limitations, and exclusions. If there is a difference between this guide and the Plan Documents, the Plan Documents prevail. |
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Option 2: Premera Blue Cross Blue Shield $2,000 HSA
With this plan you will have access to the Yukon Network. Please check with Premera to see if your provider is in the Yukon Network so that you can take advantage of greater discounts on care for you and your family.
Non-Embedded (Aggregate) Deductible
On this plan the family deductible is non-embedded — also known as aggregate — which means:
- There are no individual limits for each family member.
- The entire family shares one deductible.
Embedded Out-of-Pocket Maximums
On this plan the family out-of-pocket maximum is embedded. This means:
- Each family member has their own out-of-pocket maximum.
- There is a family-level out-of-pocket maximum.
Here’s how it works:
The plan doesn’t start paying coinsurance for anyone until the full family deductible is met. For example, the family deductible is $4,000, all family members’ costs combine toward that amount. Coinsurance begins only after the family reaches $4,000 — not when an individual reaches $2,000. The same applies to the out-of-pocket maximum: coverage at 100% starts only when the family total hits the $10,000 family out-of-pocket maximum.
| OPTION 2: $2,000 HSA YUKON NETWORK |
||
|---|---|---|
| In-Network: Preferred Providers |
In-Network: Participating Providers |
|
| Annual Deductible Jan 1 — Dec 31 Individual Maximum per Family |
You pay up to $2,000 per individual $4,000 per family |
You pay up to $2,000 per individual $4,000 per family |
| Family Deductible | Embedded | |
| Coinsurance | After the Deductible is met, you pay 20% | After the Deductible is met, you pay 40% |
| Out-of-pocket Maximum Jan 1 — Dec 31 | You pay no more than $5,000 per individual $10,000 per family |
You pay no more than $5,000 per individual $10,000 per family |
| Preventive Services | You pay $0 according to government guidelines | |
| Office Visits Primary Care Specialist |
You pay 20% AD 20% AD |
You pay 40% AD 40% AD |
| Premera Virtual Care General Medicine |
Covered in full* | |
| Diagnostic & Laboratory Services | You pay 20% AD |
You pay 40% AD |
| Mental Health Services Outpatient Inpatient |
You pay 20% AD 20% AD |
You pay 40% AD 40% AD |
| Hospital & Facility Services | You pay 20% AD |
You pay 40% AD |
| Emergency Services Freestanding Urgent Care Center Emergency Room |
You pay 20% AD 20% AD |
You pay 40% AD 40% AD |
| Rehab & Neuro Therapy Services Inpatient Rehab (30 days per calendar year) Outpatient Rehab (45 visits per calendar year) Inpatient Neuro Therapy Outpatient Neuro Therapy(45 days per calendar year) |
You pay 20% AD 20% AD 20% AD 20% AD |
You pay 40% AD 40% AD 40% AD 40% AD |
| Vision & Hearing Services | ||
| Routine Vision Exam One per calendar year |
You pay 10%* |
You pay 10%* |
| Vision Hardware Frames, Lenses, or Contacts |
Covered in full* up to $350, per calendar year | Covered in full* up to $350, per calendar year |
| Pediatric Vision Exam One per calendar year for children under age 19 |
You pay $25 copay* |
You pay $25 copay* |
| Pediatric Vision Hardware One pair of Glasses (Frames & Lenses) OR one 12-month supply of Contact Lenses per calendar year for children under age 19 |
You pay Covered in full* |
You pay Covered in full* |
| Routine Hearing Exam One per calendar year |
You pay 20%* |
You pay 20%* |
| Hearing Hardware One device per ear, every three years |
You pay 20%* |
You pay 20%* |
| Out-of-Network Costs | ||
| Deductible Individual Maximum per Family |
You pay $2,000 per Individual $4,000 per Family |
You pay $2,000 per Individual $4,000 per Family |
| Out-of-Network Individual Maximum per Family |
You pay $45,000 per Individual $90,000 per Family |
You pay $45,000 per Individual $90,000 per Family |
| Out-of-Network Coinsurance | After the Out-of-Network Deductible is met, you pay 60% | After the Out-of-Network Deductible is met, you pay 60% |
| AD: After Deductible
*Indicates deductible waived This information is designed to help you choose a benefit plan for 2026 only. Please refer to the Plan Documents provided by the carrier for information regarding coverage, limitations, and exclusions. If there is a difference between this guide and the Plan Documents, the Plan Documents prevail. |
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