Medical · BCBS PPO plan
What is the Traditional Plan?
One plan. You and your dependents each count separately.
In-network amounts. Preventive care is covered 100% with no deductible.
Traditional Plan Basics
- Preventive care is covered 100%, no cost to you.
- Two OOP Maximums: one for Medical costs, one for Prescription costs.
Traditional Plan
Deductible, single
$850
Deductible, family
$2,550
You meet $850; the other $1,700 is met by 2 or more dependents.
Most you pay in a year (out-of-pocket maximum), medical, single
$4,250
Most you pay in a year (out-of-pocket maximum), medical, family
$9,350
$4,250 for you and $5,100 for your dependents.
Most you pay in a year (out-of-pocket maximum), prescriptions, single
$2,750
Most you pay in a year (out-of-pocket maximum), prescriptions, family
$5,500
What will my medical plan cost me before it pays?
What do I pay when I use care?
Medical · using it
After the deductible, you pay 20%.
In network. Out-of-network care may cost more.
What you pay
Preventive care
Nothing. Covered 100%, no deductible.
Non-preventive care
After the deductible, 20%. The plan pays 80%.
Emergency room
After the deductible and a $100 copay, 20%.
Prescriptions
10% generic, 20% brand, 35% not on the formulary. $5 minimum.
Do this
Once you have your card, register at bluecrossmn.com/hormelfoods to see claims and costs.
Next step
Find a doctor and estimate costs at bluecrossmn.com/hormelfoods.
Next step
Make your enrollments in Oracle by 5 p.m. Central on November 16, 2026.
How are my prescriptions covered?
Check your medication, your plan’s cost share, and any approval.
Coverage for Just you
Coverage for You and your family
Most you pay in a year (out-of-pocket maximum), prescriptions
$2,750
$5,500
More about this benefit
Your medical plan determines your share
Prescription coverage is included with your medical plan. Costs depend on the medical option and whether the drug is generic, formulary brand or non-formulary brand.
A cost that does not count toward the maximum
Copayments for the difference between a brand-name product and its generic equivalent do not count toward the out-of-pocket maximum.
Check before you fill
- 1
Review covered medications in the MyPrime formulary.
- 2
Compare local pharmacy prices, generic options and home delivery.
- 3
Ask your physician to complete any required prior authorization, step therapy or quantity-limit form.
What the approval terms mean
- 1
Prior authorization: certain medications need approval.
- 2
Step therapy: another clinically appropriate or lower-cost medication may need to be tried first.
- 3
Quantity limit: a dose outside recommendations may require additional explanation.
Next step
Use MyPrime to check the formulary, compare prices or find approval forms.
Estimate your yearly cost
Turn on JavaScript to use the calculator.
Estimate for planning only, in-network care. Assumes prescriptions average 20% on the Traditional Plan. Not tax or investment advice; before acting on these results, consult a tax consultant or expert.
Where should I go for care?
Online care is the easiest place to start, and Doctor On Demand video visits are free to enrolled members and covered dependents. The $ signs show relative cost, not prices.
Where you can get care
- Online care$Common health concerns
- Retail clinic$Common illnesses in convenient retail locations
- Physician’s office$$Routine and other services during regular hours
- Urgent care$$$Office-type concerns outside regular hours
- Emergency room$$$$The most serious or life-threatening conditions
At a glance
Preventive care
Covered in-network care: $0
Emergencies
Serious / life-threatening
What comes out of your paycheck, per week
Bargaining unit · Traditional Plan · per week
| Coverage | Per week |
|---|---|
| Just you | $35 |
| You + children | $50 |
| Family | $68 |
Bargaining unit · Dental and vision · per week
| Coverage | Per week |
|---|---|
| Just you | $9 |
| You + children | $13 |
| Family | $18 |
Who to call
Blue Cross Blue Shield of MN · Medical doctor, health and fitness
Questions? Horizon Solution Center · (866) 449-7712
