BluePrime Plan

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Comprehensive coverage for those with minimal prescription drug needs.

Special Enrollment

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Consider this plan if

You seldom need prescription drugs but want comprehensive medical coverage with a low deductible.

Coverage available for

Individual
Families

Plan features

Low medical deductible
Separate prescription drug deductible
Little or no paperwork for you to manage
Low copays for doctor visits
Covers the 10 essential health benefits

Plan highlights

Free preventive visits
Extensive provider network, through ND or around the world
More predictable health care expenses
HealthyBlue online wellness center and rewards for managing your health

Gold Plans

BluePrime 70 500

Drug formularies and drug listings are reviewed on an ongoing basis and subject to change.
*After deductible is met
**Copays and coinsurance percentages apply after the RX deductible is met

Deductible

Individual: $500
Family: $1,000

Coinsurance

30% of the total cost*

Out-of-Pocket Maximums

Individual: $8,000
Family: $16,000

Preventive Visits

HealthyBlue Online Wellness

Doctor Visits

$25

Chiropractic Care, Physical, Speech and Occupational Therapy

$25

Prescription Drugs

Value Drug: $5**
Preferred Generic: $10**
Non-Preferred Generic: $10**
Preferred Brand: $60**
Non-Preferred Brand: $150**
Preferred Specialty: 40%**
Non-Preferred Specialty: 50%**

Prescription Drug Deductible

Individual: $2,500
Family: $5,000

Emergency Room Visit

30% of total cost*

Hospitalization

30% of total cost*