BlueCare Bronze 24K02-17 ($0 Virtual Visits / 3 PCP Visits for $0 then $40 / Rewards $$$) – POS
Network type: POS
Coverage tier: Expanded Bronze
Primary care visit: No charge
Specialist visit: $20 copay
Urgent care visit: $70 copay
Description
Health Care Plan Details
| Network type | POS |
| Deductible | $6,500 per person $6,500 per person |
| Out-of-pocket max | $9,450 per person $18,900 per family |
| Metal tier | Expanded Bronze |
Visit Copay
| Primary care visit | No charge |
| Specialist visit | $20 copay |
| Preventive care visit | No charge |
Urgent, Emergency Care, and Hospital Care
| Urgent care | $70 copay |
| Emergency room | $250 copay after deductible |
| Ambulance | 50% coinsurance after deductible |
| Hospital stay (facility) | $400 copay per Stay after deductible |
| Hospital stay (physician) | No charge after deductible |
| Outpatient procedure (facility) | $350 copay after deductible |
| Outpatient procedure (physician) | No charge after deductible |
| Physical rehabilitation | $70 copay |
Maternitowny and Pregnancy
| Well baby care | No charge |
| Labor, delivery, hospital stay | $400 copay after deductible |
Pharmacy, Drugs, and Medication
| Generic | $30 copay |
| Brand | 50% coinsurance after deductible |
| Non-preferred Brand | 50% coinsurance after deductible |
| Specialty | 50% coinsurance after deductible |
Lab Tests and Diagnostic Procedures
| X-rays | $100 copay after deductible |
| Imaging (CT/PET/MRI) | $20 copay |
| Blood work | $50 copay |
Mental and Psychiatric Health Care
| Mental Health outpatient services | $40 copay |
| Psychiatric hospital stay | $400 copay per Stay after deductible |
Health Plan Provider Information
| Health Plan Benefits | https://www.bcbsfl.com/DocumentLibrary/sbc/2024/24K02-17.pdf |
| Drug and medication plan formulary | https://www.myprime.com/content/dam/prime/memberportal/WebDocs/2024/Formularies/HIM/2024_FL_7T_CareChoices.pdf |
| Search doctor list | https://providersearch.floridablue.com/visitor/ffm/#/?ffmPlanCode=FFMBC |
