myBlue Silver 1604
| Plan Type: | HMO |
| Plan Tier: | Silver |
| Medical Deductible - Individual: | $5500 |
| Medical Deductible - Family: | Included in Medical |
| Drug Deductible - Individual: | $5500 |
| Drug Deductible - Family: | Included in Medical |
| Out of Pocket Max - Individual: | $7500 |
| Out of Pocket Max - Family: | $7500 |
| Primary Care Visit: | $100 |
| Specialist Visit: | $125 Copay after deductible |
| Emergency Room: | $650 Copay after deductible |
| Hospital - Physician: | No Charge |
| Hospital - Facility: | 50% Coinsurance after deductible |
| Link to Full SBC: | http://www.bcbsfl.com/DocumentLibrary/SBC/2020/1604.pdf |
| Plan Brochure: | https://www.flblue.com/plan-brochure/bc?id=1604 |
Other Coverage:
| Child Dental: | No |
| Adult Dental | No |
Prescription Drug Pricing:
| Generic Drugs: | $35 Copay after deductible |
| Non-Preferred Brand Drugs: | 50% Coinsurance after deductible |
| Preferred Brand Drugs: | $55 Copay after deductible |
| Specialty Drugs: | 50% Coinsurance after deductible |
| Link to Full Policy Formulary: | https://www.myprime.com/content/dam/prime/memberportal/forms/AuthorForms/HIM/2020/2020_FL_6T_ValueScript.pdf |
This Carrier Offers:
About The Carrier
Health Options, Inc is located in Jacksonville, FL, United States and is part of the Health Insurance Carriers Industry. Health Options, Inc has 450 total employees across all of its locations and generates $100.54 million in sales (USD).
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