BlueOptions Silver 24J01-19BS ($20 PCP Visits / Multilingual Available / Rewards $$$) – PPO

87% cost sharing reduction [Popular Plan]
Network type: PPO
Coverage tier: Silver
Primary care visit: $20 copay
Specialist visit: $40 copay
Urgent care visit: $30 copay

SKU: 16842FL026001905 Category:

Description

This plan has 87% cost sharing reduction [Popular Plan]

Health Care Plan Details

Network type PPO
Deductible $700 per person $700 per person
Out-of-pocket max $3,000 per person $6,000 per family
Metal tier Silver

Visit Copay

Primary care visit $20 copay
Specialist visit $40 copay
Preventive care visit No charge

Urgent, Emergency Care, and Hospital Care

Urgent care $30 copay
Emergency room 30% coinsurance after deductible
Ambulance 30% coinsurance after deductible
Hospital stay (facility) 30% coinsurance after deductible
Hospital stay (physician) 30% coinsurance after deductible
Outpatient procedure (facility) 30% coinsurance after deductible
Outpatient procedure (physician) 30% coinsurance after deductible
Physical rehabilitation $20 copay

Maternitowny and Pregnancy

Well baby care No charge
Labor, delivery, hospital stay 30% coinsurance after deductible

Pharmacy, Drugs, and Medication

Generic $10 copay
Brand $20 copay
Non-preferred Brand $60 copay after deductible
Specialty $250 copay after deductible

Lab Tests and Diagnostic Procedures

X-rays 30% coinsurance after deductible
Imaging (CT/PET/MRI) 30% coinsurance after deductible
Blood work 30% coinsurance after deductible

Mental and Psychiatric Health Care

Mental Health outpatient services $20 copay
Psychiatric hospital stay 30% coinsurance after deductible

Health Plan Provider Information

Health Plan Benefits https://www.bcbsfl.com/DocumentLibrary/sbc/2024/24J01-19BS.pdf
Drug and medication plan formulary https://www.myprime.com/content/dam/prime/memberportal/WebDocs/2024/Formularies/HIM/2024_FL_4T_CareChoices_Simple_Choice.pdf
Search doctor list https://providersearch.floridablue.com/visitor/ffm/#/?ffmPlanCode=FFMBOPT