myBlue Silver 2010C ($0 Deductible / $0 Virtual Visits / $0 PCP Visits / $15 Labs / $0 Generic Meds / Rewards $$$) – HMO

94% cost sharing reduction [Popular Plan]
Network type: HMO
Coverage tier: Silver
Primary care visit: No charge
Specialist visit: $2 copay
Urgent care visit: $10 copay

SKU: 30252FL007002206 Category:

Description

This plan has 94% cost sharing reduction [Popular Plan]

Health Care Plan Details

Network type HMO
Deductible Success

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Out-of-pocket max $1,200 per person $2,400 per family
Metal tier Silver

Visit Copay

Primary care visit No charge
Specialist visit $2 copay
Preventive care visit No charge

Urgent, Emergency Care, and Hospital Care

Urgent care $10 copay
Emergency room $325 copay
Ambulance 25% coinsurance
Hospital stay (facility) 25% coinsurance
Hospital stay (physician) No charge
Outpatient procedure (facility) 25% coinsurance
Outpatient procedure (physician) No charge
Physical rehabilitation $10 copay

Maternitowny and Pregnancy

Well baby care No charge
Labor, delivery, hospital stay 25% coinsurance

Pharmacy, Drugs, and Medication

Generic Share
Brand $22 copay
Non-preferred Brand 50% coinsurance
Specialty 50% coinsurance

Lab Tests and Diagnostic Procedures

X-rays $50 copay
Imaging (CT/PET/MRI) $2 copay
Blood work $15 copay

Mental and Psychiatric Health Care

Mental Health outpatient services No charge
Psychiatric hospital stay 25% coinsurance

Health Plan Provider Information

Health Plan Benefits https://www.bcbsfl.com/DocumentLibrary/sbc/2024/2010C.pdf
Drug and medication plan formulary https://www.myprime.com/content/dam/prime/memberportal/WebDocs/2024/Formularies/HIM/2024_FL_6T_ValueScript.pdf
Search doctor list https://providersearch.floridablue.com/visitor/ffm/#/?ffmPlanCode=FFMMBI