BlueCare Bronze 24K02-23 ($0 Virtual Visits / $50 PCP Visit / $30 Generic Meds / 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 $0 per person $0 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 $1,000 copay
Ambulance 50% coinsurance
Hospital stay (facility) $3,000 copay per Day
Hospital stay (physician) $300 copay
Outpatient procedure (facility) $1,500 copay
Outpatient procedure (physician) $300 copay
Physical rehabilitation $70 copay

Maternitowny and Pregnancy

Well baby care No charge
Labor, delivery, hospital stay $3,000 copay

Pharmacy, Drugs, and Medication

Generic Share
Brand $200 copay
Non-preferred Brand 50% coinsurance after deductible
Specialty 50% coinsurance after deductible

Lab Tests and Diagnostic Procedures

X-rays $120 copay
Imaging (CT/PET/MRI) $20 copay
Blood work $30 copay

Mental and Psychiatric Health Care

Mental Health outpatient services $50 copay
Psychiatric hospital stay $3,000 copay per Day

Health Plan Provider Information

Health Plan Benefits https://www.bcbsfl.com/DocumentLibrary/sbc/2024/24K02-23.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