BlueOptions Silver 24J01-07A ($0 Virtual Visits / $15 PCP Visits / $30 Specialist Visits / Rewards $$$) – PPO

Description

This plan has 73% cost sharing reduction [Popular Plan]

Health Care Plan Details

Network type	PPO
Deductible	$2,800 per person $2,800 per person
Out-of-pocket max	$6,800 per person $13,600 per family
Metal tier	Silver

Visit Copay

Primary care visit	No charge
Specialist visit	$20 copay
Preventive care visit	No charge

Urgent, Emergency Care, and Hospital Care

Urgent care	$30 copay
Emergency room	$350 copay after deductible
Ambulance	40% coinsurance after deductible
Hospital stay (facility)	$600 copay per Stay after deductible
Hospital stay (physician)	$100 copay
Outpatient procedure (facility)	$500 copay after deductible
Outpatient procedure (physician)	$100 copay
Physical rehabilitation	$30 copay

Maternitowny and Pregnancy

Well baby care	No charge
Labor, delivery, hospital stay	$600 copay after deductible

Pharmacy, Drugs, and Medication

Generic	$8 copay
Brand	$67 copay after deductible
Non-preferred Brand	50% coinsurance after deductible
Specialty	50% coinsurance after deductible

Lab Tests and Diagnostic Procedures

X-rays	$175 copay
Imaging (CT/PET/MRI)	$20 copay
Blood work	$20 copay

Mental and Psychiatric Health Care

Mental Health outpatient services	$15 copay
Psychiatric hospital stay	$600 copay per Stay after deductible

Health Plan Provider Information

Health Plan Benefits	https://www.bcbsfl.com/DocumentLibrary/sbc/2024/24J01-07A.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=FFMBOPT