Florida Blue Ppo Copay

Posted By admin On 30.04.21

Florida Blue Ppo Insurance
What Does Florida Blue Ppo Cover
Blue Medicare Ppo

Florida Blue and Florida Combined Life Insurance Company, Inc. Do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of their plans, including enrollment and benefit determinations.
Florida Blue and Florida Blue HMO do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of their plans, including enrollment and benefit determinations. FB MFT 001 NF 092016.

Coverage Summary

. Florida Blue is a PPO Plan with a Medicare contract. Enrollment in Florida Blue depends on contract renewal. You pay a $0 copay per visit. Level 2 Primary care visits: You pay a $10 copay per visit. Level 1 Specialist care visits: You pay a $35 copay per visit.

Benefit:	You Pay:
Primary Care Doctor Visit Servicios recibidos por el médico de cabecera (PCP)	$5 copayment
Specialist Visit	$45 copayment
Inpatient Hospital Care Servicios recibidos bajo admisión en un centro hospitalario	$225 copayment per day for days 1-7
Emergency Care Services Servicios recibidos en el Departamento de emergencia de un centro hospitalario, que incluye servicios profesionales y de hospital	$80 copayment; ER copay waived if admitted
Urgent Care Services Servicios recibidos en los centros ambulatorios de atención de urgencias	$25 copayment

Prescription Drug Coverage

Benefit:	You Pay:
Prescription Drug Deductible	$305 (applies to all drugs)
In-Network Prescription Drug Coverage - Initial Coverage Hasta que el costo anual por medicinas alcance $3,750	Tier 1 - Preferred Generics $3 copayment Preferred Retail (31-day supply) - Publix, Walgreens, Winn Dixie, Elevate, Pill Pack $13 copayment Standard Retail (31-day supply) - all other network retail locations $9 copayment Preferred Retail (90-day supply) $39 copayment Standard Retail (90-day supply) $9 copayment Mail Order (90-day supply) Tier 2 - Generics $10 copayment Preferred Retail (31-day supply) - Publix, Walgreens, Winn Dixie, Elevate, Pill Pack $20 copayment Standard Retail (31-day supply) - all other network retail locations $30 copayment Preferred Retail (90-day supply) $60 copayment Standard Retail (90-day supply) $30 copayment Mail Order (90-day supply) Tier 3 - Preferred Brands $47 copayment Preferred Retail (31-day supply) - Publix, Walgreens, Winn Dixie, Elevate, Pill Pack $47 copayment Standard Retail (31-day supply) - all other network retail locations $141 copayment Preferred Retail (90-day supply) $141 copayment Standard Retail (90-day supply) $141 copayment Mail Order (90-day supply) Tier 4 - Non-Preferred Brands $100 copayment Preferred Retail (31-day supply) - Publix, Walgreens, Winn Dixie, Elevate, Pill Pack $100 copayment Standard Retail (31-day supply) - all other network retail locations $300 copayment Preferred Retail (90-day supply) $300 copayment Standard Retail (90-day supply) $300 copayment Mail Order (90-day supply) Tier 5 - Speciality Drugs 27% of the costs (31-day supply) - all locations Tier 6 - Select Care Drugs $0 copayment (31-day supply) - all locations $0 copayment (90-day supply) - all locations
Coverage Gap Abit siluro gf4 mx pro driver download for windows. Después que el gasto total combinado del miembro y el plan de medicamentos sea mayor a $3,750, pero si el miembro ha pagado menos de $5,000	You pay $3 for preferred generic, 44% of the costs for generic and generic specialty drugs. You pay 35% of the costs for brand name drugs and non-generic specialty drugs.You pay $0 for Select Care drugs in the coverage gap.
Catastrophic Coverage Cuando los gastos a su cargo más el descuento de la medicina del fabricante alcancen $5,000	You pay the greater of $3.35 or 5% for preferred generic, generic and generic specialty drugs. You pay the greater of $8.35 or 5% for brand name drugs and non-generic specialty drugs.

Extra Coverage

Benefit:
Extra Benefits	Usb serial converter driver. Routine Dental Routine Hearing Routine Vision SilverSneakers Fitness Program

Out of Network Coverage

Benefit:
Medical Services/Supplies	If you receive care from an out-of-network provider, your out-of-pocket costs will usually be higher than if you use a network provider. There are three exceptions: emergency care, urgently needed care and dialysis services you receive while temporarily outside the plan service area. For details about the plan's coverage of out-of-network care, please refer to the Summary of Benefits or the Evidence of Coverage. (See 'Plan Documents' below.)
Prescription Drugs Prescription Drugs	We generally cover drugs filled at an out-of-network pharmacy only if you are not able to use one of our network pharmacies (for example, because you are traveling, need emergency or urgent care, or need a drug that it not available at an accessible network pharmacy). Chapter 5 of the Evidence of Coverage provides a full list of situations in which we may cover drugs from an out-of-network pharmacy.

Benefit:

Medical Services/Supplies

If you receive care from an out-of-network provider, your out-of-pocket costs will usually be higher than if you use a network provider. There are three exceptions: emergency care, urgently needed care and dialysis services you receive while temporarily outside the plan service area. For details about the plan's coverage of out-of-network care, please refer to the Summary of Benefits or the Evidence of Coverage. (See 'Plan Documents' below.)

Prescription Drugs

Prescription Drugs

We generally cover drugs filled at an out-of-network pharmacy only if you are not able to use one of our network pharmacies (for example, because you are traveling, need emergency or urgent care, or need a drug that it not available at an accessible network pharmacy). Chapter 5 of the Evidence of Coverage provides a full list of situations in which we may cover drugs from an out-of-network pharmacy.

Plan Documents

Florida Blue Ppo Insurance

Low Income Subsidy Premium Summary Table for Those Receiving Extra Help (PDF)

Online Member Portal

A secure members only website that keeps you in control of your health and wellness with a variety of easy-to-use tools.

What Does Florida Blue Ppo Cover

Fitness Program

SilverSneakers gives you unlimited access to over 14,000 gyms and wellness programs. Enjoy services like fitness classes, treadmills, weights, pools and more at no extra cost to you.

Case Management Coordination of Care

A dedicated consultant to assist with coordinating appointments, in or outpatient stays, management of chronic conditions and help with finding the best price on procedures and prescriptions.

Florida Blue Centers/FHCP Centers

Blue Medicare Ppo

Enjoy face-to-face customer service, wellness events and educational seminars at one of our unique retail centers.