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Individuals and Families: BlueChoice
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BlueChoice Benefits Summary
No matter how you tailor your coverage, you'll enjoy these benefits:
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Basic Provisions
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Physician Benefits
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Choice of deductibles
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$2 million lifetime maximum
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Calendar-year deductible
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Deductible carryover
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Calendar-year benefit period (Jan. 1 - Dec. 31)
- Maximum of two deductibles per family, per calendar year.
- Dependents covered until age 19 or age 25 if child is full-time student; no age
limit for disabled children (certain rules apply)
Hospital Benefits
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Operation and recovery rooms (includes outpatient surgery)
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Semi-private room and board
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Intensive care
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Required diagnostic X-ray and lab tests
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Anesthesia services
- Drugs and supplies
Outpatient Benefits
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Physician outpatient care
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Surgery
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Radiological therapy
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Injectible chemotherapy
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Emergency room visits ($200 copay; waived if admitted to the hospital)
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Outpatient X-ray and lab tests
- Drugs and supplies
Prescription Benefits
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Office visits
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In-hospital visits
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Surgery
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Outpatient X-ray and lab tests
- Durable medical equipment
Children's Preventive Care
- Well-patient services (office visits only) covered 100%
Wellness Benefits
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Physical exams
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Routine gynecological exams and more
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Up to a $500 annual maximum (per person) in benefits
- Copayments and deductibles do not apply; applicable coinsurance does apply
NOTE: Our BlueChoice insurance policy does not provide
coverage for mental health services, including treatment for alcoholism, drug addiction,
and psychiatric conditions. Since applications for BlueChoice take time to process
and you are not guaranteed coverage, we advise you to keep your current coverage
in effect until we notify you that your new coverage is active.
Preexisting Condition Exclusion Period: Treatment of
preexisting conditions or diseases, until this policy has been in effect continuously
for twelve (12) months, are not covered. This means a condition or disease which
causes symptoms, before the effective date, that would have caused an ordinarily
prudent person to seek diagnosis, care or treatment. This also applies to aggravations
of such conditions or diseases. There is NO credit given toward the preexisting
condition period for prior health insurance.
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Choose Your Plan Options
Choose the deductible, coinsurance or copayment amounts that work best for you.
Select a prescription drug plan. Add maternity benefits if you need them. Deductibles
range from $500 to $25,000. You also can add term life insurance, with benefit amounts
ranging from $10,000 to $50,000, and critical illness coverage.
Important Note: This Web site contains a summary of benefits available to you through
BlueChoice; it is not your insurance contract. Please refer to your
policy for a complete list of limitations and exclusions.
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