Florida Blue Teladoc Copay
If you are a Florida Blue member, you can also obtain your current SBC anytime by logging into the Florida Blue Member Portal. Use the Search box below to search for an SBC by Group Number or Plan Number. If you are unable to locate your SBC, or wish to have an SBC sent to you free of charge, call 1-800-352-2583. For TTY/TDD call 1-800-955-8771. BlueCare All Copay 1565 Plans Florida Blue provides Plan Brochures and Summaries of Benefits and Coverage (SBC) for each of our plans. These documents highlight key features of your plan or coverage, such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions.
Basic Option | |
---|---|
Preventive Care | Nothing for covered preventive screenings, immunizations and services |
Physician Care | $30 for primary care1 $40 for specialists1 |
Virtual doctor visits by Teladoc® | $0 for first 2 visits $15 all additional visits |
Urgent Care Center | $35 copay |
Prescription Drugs | Preferred Retail Pharmacy: Tier 1 (Generics): $10 copay Tier 2 (Preferred brand): $55 copay2 Tier 3 (Non-preferred brand): 60% of our allowance ($75 minimum)2 Tier 4 (Preferred specialty): $65 copay2 Tier 5 (Non-preferred specialty): $90 copay2 Mail Service Pharmacy: Available to members with Medicare Part B primary only. Visit the Medicare page for more information. Tier 1 (Generics): $20 Tier 2 (Preferred brand): $100 copay Tier 3 (Non-preferred brand): $125 copay Specialty Pharmacy: Tier 4 (Preferred specialty): $85 copay2 Tier 5 (Non-preferred specialty): $110 copay2 |
Maternity Care | $175 inpatient $0 outpatient |
Hospital Care | Inpatient (Precertification is required): $175 per day; up to $875 per admission Mackeeper 4. Outpatient: $100 per day per facility1 |
Surgery | $150 in an office setting1 $200 in a non-office setting1 |
ER (accidental injury) | $175 per day per facility |
ER (medical emergency) | $175 per day per facility |
Lab work (such as blood tests) | $0 copay1 |
Diagnostic services (such as sleep studies, CT scans) | Cisco vpn download. Up to $100 in an office1 Up to $150 in a hospital1 |
Chiropractic Care | $30 per treatment; up to 20 visits per year |
Dental Care | $30 copay per evaluation; up to 2 per year |
Rewards Program | Earn $50 for completing the Blue Health Assessment3 Earn up to $120 for completing three eligible Online Health Coach goals3 |
Blue Care All Copay 17251
Jacksonville, Florida 32246. Florida Blue HMO is a trade name of Health Options, Inc., an HMO subsidiary of Blue Cross and Blue Shield of Florida, Inc. D/B/A Florida Blue. These companies are Independent Licensees of the Blue Cross and Blue Shield Association. BCRQ.IU.BB.BNO-ND 0914 BCRQ.IU.BB 0413.