Plan features
Preventive services are covered with no deductible or copay. Beyond that, BlueCare members pay a set copayment for doctor, chiropractor, therapy and prescriptions and a percentage of inpatient/outpatient hospitalization costs.
In addition to health care coverage, BlueCare includes HealthyBlue online wellness center with powerful tools employees can use to manage their health and well-being.
Plan highlights
- A traditional health care plan
- Opportunities to adjust employee contributions and cost-sharing amounts
- Employees pay a set cost for most office visits
- Preventive coverage with no deductible or copay
- Plans include HealthyBlue online wellness center, powered by WebMD
Amounts indicated are your share of the medical expenses.
| Platinum Plans | Gold Plans | Silver Plan | |||
|---|---|---|---|---|---|
| BlueCare 90 500 | BlueCare 80 250 | BlueCare 80 1000 | BlueCare 70 1800 | BlueCare 60 3000 | |
| Available to Businesses Based in | All N.D. counties | All N.D. counties | All N.D. counties | All N.D. counties | All N.D. counties |
| Deductible |
Individual: $500 Family: $1,000 |
Individual: $250 Family: $500 |
Individual: $1,000 Family: $2,000 |
Individual: $1,800 Family: $3,600 |
Individual: $3,000 Family: $6,000 |
| Out-of-pocket Maximums |
Individual: $1,800 Family: $3,600 |
Individual: $2,500 Family: $5,000 |
Individual: $8,150 Family: $16,300 |
Individual: $6,000 Family: $12,000 |
Individual: $9,400 Family: $18,800 |
| Coinsurance | 10% of total cost* | 20% of total cost* | 20% of total cost* | 30% of total cost* | 40% of total cost* |
| Preventive Visits | $0 | $0 | $0 | $0 | $0 |
| HealthyBlue Online Wellness | $0 | $0 | $0 | $0 | $0 |
| Doctor Visits, Chiropractic Care, Physical, Speech and Occupational Therapy | $20 | $20 | $40 | $20 | $45 |
| Prescription Drugs |
Value Drugs: $5 Preferred Generic: $5 Non-Preferred Generic: $5 Preferred Brand: $20 Non-Preferred Brand: $40 Preferred Specialty: 20%* Non-Preferred Specialty: 50%* |
Value Drugs: $5 Preferred Generic: $10 Non-Preferred Generic: $10 Preferred Brand: $20 Non-Preferred Brand: $40 Preferred Specialty: 30%* Non-Preferred Specialty: 50%* |
Value Drugs: $5 Preferred Generic: $5 Non-Preferred Generic: $5 Preferred Brand: $50 Non-Preferred Brand: $150 Preferred Specialty: 30%* Non-Preferred Specialty: 50%* |
Value Drugs: $5 Preferred Generic: $20 Non-Preferred Generic: $20 Preferred Brand: $80 Non-Preferred Brand: $100 Preferred Specialty: 40%* Non-Preferred Specialty: 50%* |
Value Drugs: $5 Preferred Generic: $20 Non-Preferred Generic: $20 Preferred Brand: $150 Non-Preferred Brand: $200 Preferred Specialty: 50%* Non-Preferred Specialty: 50%* |
| Specialist Visit | $20 | $20 | $40 | $20 | $45 |
| Emergency Room Visit | Deductible and coinsurance applies | Deductible and coinsurance applies | Deductible and coinsurance applies | Deductible and coinsurance applies | Deductible and coinsurance applies |
| Hospitalization | Deductible and coinsurance applies | Deductible and coinsurance applies | Deductible and coinsurance applies | Deductible and coinsurance applies | Deductible and coinsurance applies |
| Telehealth | $0 | $0 | $0 | $0 | $0 |
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(Compare up to 3 plans) |
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All cost sharing amounts apply to covered services you receive within the Preferred Blue PPO
network. Covered services received out-of-network are paid at a lesser benefit or no benefit amount.
For a family plan, an individual on the plan must meet the individual deductible before coinsurance begins. The BlueCare prescription drug coverage is considered creditable coverage. *After deductible is met. |
