Florida Blue BlueOptions Everyday Health 1420 FL

Plan Information
Company Florida Blue (BlueCross BlueShield FL)
State FL
Metal Tier Gold
Plan Type EPO

Cost Sharing Benefits

Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $2,500 $8,000
Deductible (Family) $5,000 $16,000
Coinsurance 20% 50%
Out of Pocket Maximum (Individual) $6,250 $16,000
Out of Pocket Maximum (Family) $12,500 $25,000
Services In Network Out of Network
Primary Care Visit $20 50% coinsurance
Specialist Visit $50 50% coinsurance
In Patient Hospital Services 20% Coinsurance after deductible 50% coinsurance
Emergency Room Services 20% Coinsurance after deductible 20% coinsurance
Mental / Behavioral Health $50 copay 50% coinsurance
Imaging (CT/PET Scans, MRIs) 20% coinsurance 50% coinsurance
Rehabilitative Speech Therapy 20% coinsurance 50% coinsurance
Rehabilitative Occupational & Physical Therapy 20% coinsurance 50% coinsurance
Preventative Care $0 50% coinsurance
Laboratory Outpatient and Professional Services $0 50% coinsurance
X-ray and Diagnostic Imaging 20% coinsurance 50% coinsurance
Outpatient Facility 20% coinsurance 50% coinsurance
Outpatient Surgery 20% coinsurance 50% coinsurance
Prescription Drugs In Network Out of Network
Generic Rx $10
Preferred Brand Rx $40
Non Preferred Brand Rx $70
Specialty Drugs $150

Other Plans

Other plans that are available in the state.

Plan Name
BlueOptions All Copay 1424
BlueOptions All Copay Plus 1424P
BlueOptions Catastrophic 1433
BlueOptions Essential (HSA) 1419
BlueOptions Essential (HSA) 1430
BlueOptions Essential (HSA) Plus 1419P
BlueOptions Essential (HSA) Plus 1430P
BlueOptions Essential 1401
BlueOptions Essential 1406
BlueOptions Essential Plus 1401P
BlueOptions Essential Plus 1406P
BlueOptions Everyday Health 1410
BlueOptions Everyday Health 1416
BlueOptions Everyday Health 1418
BlueOptions Everyday Health 1420
BlueOptions Everyday Health 1431
BlueOptions Everyday Health Plus 1410P
BlueOptions Everyday Health Plus 1416P
BlueOptions Everyday Health Plus 1418P
BlueOptions Everyday Health Plus 1420P
BlueOptions Everyday Health Plus 1431P
BlueOptions Everyday Health Premier 1418V
BlueOptions Everyday Health Premier 1420V
BlueOptions Predictable Cost 1413
BlueOptions Predictable Cost 1423
BlueOptions Predictable Cost Plus 1413P
BlueOptions Predictable Cost Plus 1423P
BlueSelect All Copay 1457
BlueSelect All Copay Plus 1457P
BlueSelect Essential (HSA) 1452
BlueSelect Essential (HSA) 1463
BlueSelect Essential (HSA) Plus 1452P
BlueSelect Essential (HSA) Plus 1463P
BlueSelect Essential 1434
BlueSelect Essential 1439
BlueSelect Essential Plus 1434P
BlueSelect Essential Plus 1439P
BlueSelect Everyday Health 1443
BlueSelect Everyday Health 1449
BlueSelect Everyday Health 1451
BlueSelect Everyday Health 1453
BlueSelect Everyday Health 1464
BlueSelect Everyday Health Plus 1443P
BlueSelect Everyday Health Plus 1449P
BlueSelect Everyday Health Plus 1451P
BlueSelect Everyday Health Plus 1453P
BlueSelect Everyday Health Plus 1464P
BlueSelect Everyday Health Premier 1451V
BlueSelect Everyday Health Premier 1453V
BlueSelect Predictable Cost 1446
BlueSelect Predictable Cost 1456
BlueSelect Predictable Cost Plus 1446P
BlueSelect Predictable Cost Plus 1456P
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