myBlue Connected Care Silver 2332 ($0 Virtual Visits / $0 Primary Care Visits with Select Providers / 24×7 Provider Access / Disponible en Español / Rewards $$$)

30252FL0070049
Silver
HMO

myBlue Connected Care Silver 2332 ($0 Virtual Visits / $0 Primary Care Visits with Select Providers / 24×7 Provider Access / Disponible en Español / Rewards $$$) is a Silver HMO plan by Florida Blue HMO (a BlueCross BlueShield FL company).

IMPORTANT: You are viewing the 2023 version of myBlue Connected Care Silver 2332 ($0 Virtual Visits / $0 Primary Care Visits with Select Providers / 24×7 Provider Access / Disponible en Español / Rewards $$$) 30252FL0070049. You can enroll in this plan if you qualify for special enrollment until the end of 2023.

Locations

myBlue Connected Care Silver 2332 ($0 Virtual Visits / $0 Primary Care Visits with Select Providers / 24×7 Provider Access / Disponible en Español / Rewards $$$) is offered in the following counties.

Plan Overview

This is a plan overview for 2023 version of myBlue Connected Care Silver 2332 ($0 Virtual Visits / $0 Primary Care Visits with Select Providers / 24×7 Provider Access / Disponible en Español / Rewards $$$) 30252FL0070049.
Insurer: Florida Blue HMO (a BlueCross BlueShield FL company)
Network Type: HMO
Metal Type: Silver
HSA Eligible?: No
Plan ID: 30252FL0070049

Cost-Sharing Overview

myBlue Connected Care Silver 2332 ($0 Virtual Visits / $0 Primary Care Visits with Select Providers / 24×7 Provider Access / Disponible en Español / Rewards $$$) offers the following cost-sharing.

Notes:

  • Some plans have separate cost-sharing for medical and drugs, while other plans offer combined cost-sharing. The cost-sharing amounts above are combined medical and drug costs unless otherwise noted.
  • You are viewing the standard version of this plan. Your costs may be lower depending on your income. Use the “get a quote” button below to see your estimated premium and out-of-pocket costs after assistance.
Ready to sign up for myBlue Connected Care Silver 2332 ($0 Virtual Visits / $0 Primary Care Visits with Select Providers / 24x7 Provider Access / Disponible en Español / Rewards $$$)?

Click or call to enroll online, get a quote, or find out if you qualify for assistance.
Get Help from a licensed agent. 1-877-668-0904

Plan Features

myBlue Connected Care Silver 2332 ($0 Virtual Visits / $0 Primary Care Visits with Select Providers / 24×7 Provider Access / Disponible en Español / Rewards $$$) offers the following features and referral requirements.

Wellness Program: No
Disease Program: Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Pain Management, Pregnancy
Notice Pregnancy: No
Referral Specialist: Yes
Specialist Requiring Referral: All Specialists require a referral with the exception of Chiropractors, Podiatrists, Dermatologists and Obstetric/Gynecologists.
Plan Exclusions:
Child Only Option?: Allows Adult and Child-Only

Network Details

The following network details will help you understand what myBlue Connected Care Silver 2332 ($0 Virtual Visits / $0 Primary Care Visits with Select Providers / 24×7 Provider Access / Disponible en Español / Rewards $$$) covers when you are out of the service area or out of the country.

Out of Country Coverage: Yes
Out of Country Coverage Description: Accident and emergency services.
Out of Service Area Coverage: Yes
Out of Service Area Coverage Description: Accident and emergency services.
National Network: No

Additional Benefits and Cost-Sharing

myBlue Connected Care Silver 2332 ($0 Virtual Visits / $0 Primary Care Visits with Select Providers / 24×7 Provider Access / Disponible en Español / Rewards $$$) includes the following benefits at the cost sharing rates listed below.

Service In-Network
Copay / Coinsurance
Out-of-Network
Copay / Coinsurance
Limits and Explanation
Primary Care Visit to Treat an Injury or Illness
Covered
No Charge 100.00% No charge for unlimited visits rendered by Value Choice Providers. Check your Online Provider Directory for providers in your area.
Specialist Visit
Covered
$20.00 100.00% Lower out of pocket costs for virtual visits and reduced cost available at Value Choice Providers. Check your Online Provider Directory for providers in your area.
Other Practitioner Office Visit (Nurse, Physician Assistant)
Covered
$100.00 Copay after deductible 100.00%
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Covered
50.00% Coinsurance after deductible 100.00%
Outpatient Surgery Physician/Surgical Services
Covered
50.00% Coinsurance after deductible 100.00%
Hospice Services
Covered
No Charge 100.00%
Routine Dental Services (Adult)
Not Covered
Infertility Treatment
Not Covered
Long-Term/Custodial Nursing Home Care
Not Covered
Private-Duty Nursing
Not Covered
Routine Eye Exam (Adult)
Not Covered
Urgent Care Centers or Facilities
Covered
$100.00 Copay after deductible 100.00% Reduced cost available at Value Choice Providers. Check your Online Provider Directory for providers in your area.
Home Health Care Services
Covered
No Charge 100.00%60 Visit(s) per Benefit Period
Emergency Room Services
Covered
50.00% Coinsurance after deductible 50.00% Coinsurance after deductible
Emergency Transportation/Ambulance
Covered
50.00% Coinsurance after deductible 50.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)
Covered
50.00% Coinsurance after deductible 100.00%
Inpatient Physician and Surgical Services
Covered
50.00% Coinsurance after deductible 100.00%
Bariatric Surgery
Not Covered
Cosmetic Surgery
Not Covered
Skilled Nursing Facility
Covered
$500.00 Copay per Stay 100.00%60 Days per Benefit Period
Prenatal and Postnatal Care
Covered
$100.00 Copay after deductible 100.00%
Delivery and All Inpatient Services for Maternity Care
Covered
50.00% Coinsurance after deductible 100.00%
Mental/Behavioral Health Outpatient Services
Covered
$100.00 Copay after deductible 100.00%
Mental/Behavioral Health Inpatient Services
Covered
50.00% Coinsurance after deductible 100.00%
Substance Abuse Disorder Outpatient Services
Covered
$100.00 Copay after deductible 100.00%
Substance Abuse Disorder Inpatient Services
Covered
50.00% Coinsurance after deductible 100.00%
Generic Drugs
Covered
$35.00 Copay after deductible 100.00% In-Network Only: $0 preventive and $4 generics for certain drugs, plus Mail Order for these drugs is $0.
Preferred Brand Drugs
Covered
$55.00 Copay after deductible 100.00% In-Network Only: Certain drugs are available for a lower cost.
Non-Preferred Brand Drugs
Covered
50.00% Coinsurance after deductible 100.00%
Specialty Drugs
Covered
50.00% Coinsurance after deductible 100.00%
Outpatient Rehabilitation Services
Covered
$100.00 Copay after deductible 100.00%35 Visit(s) per Benefit Period Combined limit for all outpatient therapy plus chiropractic.
Habilitation Services
Covered
$100.00 Copay after deductible 100.00%35 Visit(s) per Benefit Period Supplementing with the federal definition of habilitative services: Health care services that help a person keep, learn, or improve skills and functioning for daily living. Examples include therapy for a child who is not walking or talking at the expected age. These services may include physical and occupational therapy, speech-language pathology and other services for people with disabilities in a variety of inpatient and/or outpatient settings.
Chiropractic Care
Covered
$100.00 Copay after deductible 100.00%35 Procedure(s) per Benefit Period Combined limit for all outpatient therapy plus chiropractic.
Durable Medical Equipment
Covered
No Charge 100.00%
Hearing Aids
Not Covered
Imaging (CT/PET Scans, MRIs)
Covered
50.00% Coinsurance after deductible 100.00%
Preventive Care/Screening/Immunization
Covered
No Charge 100.00%
Routine Foot Care
Covered
$20.00 100.00% Only covered when medically necessary. Reduced cost available at Value Choice Providers. Check your Online Provider Directory for providers in your area.
Acupuncture
Not Covered
Weight Loss Programs
Not Covered
Routine Eye Exam for Children
Covered
No Charge 100.00%1 Visit(s) per Year
Eye Glasses for Children
Covered
No Charge 100.00%1 Item(s) per Year
Dental Check-Up for Children
Not Covered
Rehabilitative Speech Therapy
Covered
$100.00 Copay after deductible 100.00%35 Visit(s) per Benefit Period Combined limit for all outpatient therapy plus chiropractic.
Rehabilitative Occupational and Rehabilitative Physical Therapy
Covered
$100.00 Copay after deductible 100.00%35 Visit(s) per Benefit Period Combined limit for all outpatient therapy plus chiropractic.
Well Baby Visits and Care
Covered
No Charge 100.00%
Laboratory Outpatient and Professional Services
Covered
$25.00 100.00%
X-rays and Diagnostic Imaging
Covered
$40.00 100.00%
Basic Dental Care – Child
Not Covered
Orthodontia – Child
Not Covered
Major Dental Care – Child
Not Covered
Basic Dental Care – Adult
Not Covered
Orthodontia – Adult
Not Covered
Major Dental Care – Adult
Not Covered
Abortion for Which Public Funding is Prohibited
Not Covered
Transplant
Covered
50.00% Coinsurance after deductible 100.00%
Accidental Dental
Covered
$100.00 Copay after deductible 100.00%
Dialysis
Covered
50.00% Coinsurance after deductible 100.00%
Allergy Testing
Covered
$100.00 Copay after deductible 100.00%
Chemotherapy
Covered
50.00% Coinsurance after deductible 100.00%
Radiation
Covered
50.00% Coinsurance after deductible 100.00%
Diabetes Education
Covered
No Charge 100.00%
Prosthetic Devices
Covered
No Charge 100.00%
Infusion Therapy
Covered
50.00% Coinsurance after deductible 100.00%
Treatment for Temporomandibular Joint Disorders
Covered
$100.00 Copay after deductible 100.00%
Nutritional Counseling
Covered
$20.00 100.00% Reduced cost available at Value Choice Providers. Check your Online Provider Directory for providers in your area. Diabetes coverage includes ‘nutrition counseling’; home health services include ‘nutritional guidance’.
Reconstructive Surgery
Covered
50.00% Coinsurance after deductible 100.00% Only for Breast reconstruction following a Mastectomy.
Gender Affirming Care
Covered
50.00% Coinsurance after deductible 100.00% Only covered when medically necessary.
Diabetes Care Management
Covered
$100.00 Copay after deductible 100.00%
Off Label Prescription Drugs
Covered
50.00% Coinsurance after deductible 100.00%
Dental Anesthesia
Covered
$100.00 Copay after deductible 100.00%
Congenital Anomaly, including Cleft Lip/Palate
Covered
50.00% Coinsurance after deductible 100.00%
Bone Marrow Transplant
Covered
50.00% Coinsurance after deductible 100.00%
Nutrition/Formulas
Covered
50.00% Coinsurance after deductible 100.00%
Osteoporosis
Covered
$20.00 100.00% Reduced cost available at Value Choice Providers. Check your Online Provider Directory for providers in your area.

Free Preventive Services

There is no copayment or coinsurance for any of the following myBlue Connected Care Silver 2332 ($0 Virtual Visits / $0 Primary Care Visits with Select Providers / 24×7 Provider Access / Disponible en Español / Rewards $$$) preventive services. This is true even if you haven’t met your yearly deductible.

Please note, these services are free only when delivered by a doctor or other provider in your plan’s network.

Additional Resources

Below are additional resources for myBlue Connected Care Silver 2332 ($0 Virtual Visits / $0 Primary Care Visits with Select Providers / 24×7 Provider Access / Disponible en Español / Rewards $$$) including the Summary of Benefits & Coverage (SBC), plan brochure, formulary link, and a link to the website to pay your monthly premium after you enroll.

Summary of Benefits: Summary of Benefits Link
Plan Brochure: Plan Brochure Link
Formulary: Formulary Link
Premium Payment Website: Premium Payment Link
Ready to sign up for myBlue Connected Care Silver 2332 ($0 Virtual Visits / $0 Primary Care Visits with Select Providers / 24x7 Provider Access / Disponible en Español / Rewards $$$)?

Click or call to enroll online, get a quote, or find out if you qualify for assistance.
Get Help from a licensed agent. 1-877-668-0904

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