Medical
We offer a comprehensive benefits program to help you and your family protect your health and financial security. Your benefits are a valuable part of your compensation; we encourage you to learn how your plans work so you can get the most from them.
You have two medical plan options through Florida Blue.
Watch this video to learn more about your
Medical Plans
Medical Highlights (In-Network)
For complete details, exclusions and limitations, and out-of-network benefits, see the Certificates of Coverage.
PPO
03559
Plan Year Deductible (Individual / Family)
$500 / $1,500
Your Coinsurance (% you pay)
20%
Out-of-Pocket Maximum (Individual / Family)
$3,000 / $9,000
Preventive Services
$0
Teladoc Virtual Visits:
General Medicine / Dermatology: $0 Mental Health: $35
Office Visits
Primary Care Physician: $35 Specialist: CYD, then 20%
Urgent Care
$35
Emergency Room Visit
CYD, then 20%
Benefit Maximums per Calendar Year
Acupuncture Visits
30
Outpatient Therapies*
75
*Calendar Year combined days/visits. Physical, Occupational and Speech Therapy.
Chiropractic*
26
*More than 5 chiropractic visits require provider authorization through Florida Blue/ASH.
Home Health Care Visits
20
Inpatient Rehabilitation Days
30
Skilled Nursing Facility Days
60
PPO with HRA
05360
Plan Year Deductible (Individual / Family)
$1,500 / $3,000
Your Coinsurance (% you pay)
20%
Out-of-Pocket Maximum (Individual / Family)
$4,500 / $9,000
Preventive Services
$0
Teladoc Virtual Visits:
General Medicine / Dermatology: $0 Mental Health: $35
Office Visits
Primary Care Physician: $35 Specialist: CYD, then 20%
Urgent Care
$35
Emergency Room Visit
CYD, then 20%
Benefit Maximums per Calendar Year
Acupuncture Visits
30
Outpatient Therapies*
75
*Calendar Year combined days/visits. Physical, Occupational and Speech Therapy.
Chiropractic*
26
*More than 5 chiropractic visits require provider authorization through Florida Blue/ASH.
Home Health Care Visits
20
Inpatient Rehabilitation Days
30
Skilled Nursing Facility Days
60
Quest Diagnostics
Florida Blue has an arrangement with Quest Diagnostics that provides even deeper discounts than other in-network outpatient lab facilities, such as outpatient hospital and other free-standing labs.
If you are outside of Florida, you can visit any participating independent lab in your area.
WHAT IS A...
Deductible: Amount you have to pay for a covered medical expense before your coinsurance kicks in.
Coinsurance: A percentage of the claim amount you pay (after your deductible is met), while your insurance plan pays for the rest. For example: You pay 20% and the plan pays 80%.
Copay: Fixed fee you may need to pay for healthcare services (i.e., office visits, prescriptions).
Out-of-Pocket Maximum: You will not have to pay more than this amount during your plan year – once you reach it, your insurance plan will cover all additional covered expenses.
Additional Florida Blue Resources
Florida Blue Health & Wellbeing Tools
Teladoc
800.835.2362
www.TeladocHealth.com
- Teladoc provides you with a convenient and affordable way to receive quality medical care.
- Talk with board-certified, state- licensed doctors by phone or video anytime, anywhere.
Care Assistance Programs
- Care Consultants provide assistance in comparing your choices for medical services or prescriptions. Call 888.476.2227.
- Health Coaches are licensed nurses available 24/7 to provide support with significant medical decisions and symptom management. Call 877.789.2583.
- Care Management Programs help you or a covered dependent living with a chronic condition, including Diabetes, Congestive Heart Failure, Chronic Obstructive Lung Disease (COPD), Asthma, or Cardiac Conditions. Call 800.955.5692 or visit www.FloridaBlue.com.
Diabetic Resources
877.789.2583
- Personalized diabetic resources are available 24/7 through Health Dialog.
- With member cost sharing, Insulin is covered through the pharmacy program while diabetic supplies are covered through Florida Blue's CareCentrix.
- Through Transform Diabetes Care, managed by the pharmacy program, members can get lancets and test strips at no cost.
Nicotine Cessation
844.278.5590
- We know quitting nicotine is not easy. That is why the prescription plan provides coverage for a 168-daysupply per calendar year per medication.
- Coverage is included for over-the-counter products, generic prescription medications, and branded Nicotrol NS Nasal Spray, Nicotrol Inhaler System, and Chantix.
Mental Health Benefits
- To find an in-person Mental Health Clinician, visit www.FloridaBlue.com or call 866.350.2280.
- To access virtual Mental Health Care, visit www.TeladocHealth.com.
- To access virtual or in-person mental health support and coaching through Spring Health visit www.SJC.SpringHealth.com or call 855-629-0554.
- Florida Blue has partnered with Lucet to provide behavioral health services and support. To access resources or connect with provider, visit LucetHealth.com or call 866.287.9569.
Discounts
View hundreds of discounts available to you, including hearing devices, fitness equipment, homeopathic health services, and much more.
Home Health & DME Providers
877.561.9910
- CareCentrix, Florida Blue's Durable Medical Equipment (DME) supplier, has an established network of providers who are accessible throughout Florida.
- DME is any medical equipment used in the home to aid in a better quality of living.
- When prescribed by your doctor and medically necessary, Florida Blue will cover these items at 80% after your in-network deductible is met, and as long as you go through CareCentrix.