How Health Coverage Works
Having health coverage means you won’t have to pay the whole cost of care on your own.
What does health insurance cover?
When you enroll in a health plan, you and/or your employer pay a monthly bill, and we’ll pay part of the cost for your covered medical services, like doctor or hospital visits or prescription drugs. To see your benefits now, log in and click My Plan.
What's the difference between HMO and PPO plans?
Florida Blue's HMO plans, myBlue, BlueCare and SimplyBlue, feature a primary care doctor who coordinates your health care, sometimes including referrals to specialists. Also, with an HMO plan, unless it's an emergency, you only have coverage for care and supplies from providers in your plan's network. Our PPO plans, BlueOptions and BlueSelect, do offer out-of-network coverage and you can manage your care, including choosing doctors and specialists, on your own.
We've got a range of HMO and PPO plans to meet your needs, and many include $0 copay preventive care and virtual visits, the opportunity for every covered adult to earn rewards and more.
What's the difference between premiums and out-of-pocket expenses like deductible, coinsurance and copays?
Your premium is the amount you or your employer pay every month for your health plan. Besides your monthly premium, most plans have additional out-of-pocket costs. Your deductible is the dollar amount you pay for certain covered services before your plan helps pay for in-network services. The amount you pay for care may either be a copay (a fixed amount) or coinsurance (a percentage of the costs for a covered service)— generally after you meet your deductible. You usually pay this amount at the time you receive a covered health care service. How much you pay depends on which plan you’re enrolled in. To see your benefits now, log in and click My Plan.
Click here for some other common health coverage terms that may be helpful.