Medical Coverage
Your Cost & Coverage Options for Medical InsuranceOur Medical Insurance Provider
You may see our medical insurance provider referred to as Blue Cross and Blue Shield of Florida, BCBSFL, or Florida Blue. These names are interchangeable and all refer to the same provider.
Discontinued Plans for 2026
If your 2025 medical plan was the Choice HRA, Value HRA, or Value HSA and you did not take action to change your election during Open Enrollment, you were automatically moved into the available plan that most closely aligned with your 2025 election, as follows:
- Choice HRA → Value PPO
- Value HRA → Value PPO
- Value HSA → Choice HSA
Medical Insurance
Benefits-eligible Team Members have a choice of three medical insurance plans administered by Blue Cross and Blue Shield of Florida, also known as BCBSFL or Florida Blue.
Geting Started
- First, use the information below to compare the coverage offered and what you would pay for each plan. For pharmacy coverage, visit the Pharmacy Benefits page.
- Then, learn how you can use your medical plan and, if applicable, your health savings account (HSA) or flexible spending account (FSA).
- Once you’re a member, activate your account in My Health Toolkit to take advantage of services, programs, and resources from BCBSFL.
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Activate Your My Health Toolkit Account
After you’ve enrolled in a BCBSFL medical plan, your My Health Toolkit account so that you have easy access to your member ID card, plan coverage details, in-network care locator, and claims.
Find an In-Network Doctor
You can use the Find Care section of your My Health Toolkit account to find a provider that is covered by your plan.
Blue Cross & Blue Shield of Florida (BCBSFL) or Florida Blue
Medical
Contact Information
Phone: 1-833-578-1132
Plan Options, Costs & Coverage
There are three BCBSFL medical plan options for you to choose from: the Choice PPO, the Value PPO, and the Choice HSA.
- Under all plans, you can see any doctor (including specialists) or use any hospital in the network: no referrals are required and you don’t need to choose a primary care physician (PCP).
- When you receive care outside of the network, you are covered by insurance, but your costs will be higher.
- Preventive care is covered 100% with in-network providers.
Plan highlights are outlined below. If you are enrolling for the first time, make sure to review the plan comparison and rate charts in the next section for detailed cost and coverage information for the 2026 plan year.
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Value PPO & Choice PPO
The Value PPO and Choice PPO medical plan options have set copays for office visits and some prescription drugs.
Who can enroll? All benefits-eligible employees will be able to enroll.
Deductibles:
- The Value PPO plan has a $6,550 deductible for individual coverage or a $13,100 deductible for family coverage.
- The Choice PPO plan has a $3,500 deductible per person with a $7,000 family maximum.
FSAs and HSAs: If you choose the Value PPO plan or the Choice PPO plan, you will be able to set aside pretax dollars in the Health Care Flexible Spending Account (FSA) to help pay for eligible expenses.
What you’ll pay: Your per-paycheck deduction will depend on your salary and the medical plan you choose.
Choice HSA
In addition to the new Value PPO and Choice PPO plans, you’ll have the option to enroll the Choice HSA plan.
Who can enroll? All benefits-eligible employees will be able to enroll.
Deductible: The Choice HSA plan has a $4,000 deductible for individual coverage or a $8,000 deductible for family coverage.
FSAs and HSAs: The Choice HSA plan still has a Health Savings Account (HSA) available.
What you’ll pay: Your per-paycheck deduction will depend on your salary and the medical plan you choose.
Wellness Premium Discount
Your per-paycheck deduction will depend on your salary, the medical plan you choose, and whether or not you and your covered spouse completed the wellness program requirements in 2025 to earn a premium discount.
- If you only cover yourself, the wellness premium discount is $17.31 per paycheck.
- If you cover a spouse and they also completed the wellness program requirements, you are eligible for an additional $17.31 biweekly discount.
For more information about this program, follow this link: Wellness & Health Rewards Program.
2026 Medical Plan Coverage Comparison
| Value PPO | Choice PPO | Choice HSA | |
|---|---|---|---|
| Calendar Year Deductibles1 | |||
| Individual Coverage | $6,550 individual | $3,500 per person | $4,000 individual |
| Family Coverage | $13,100 family | $7,000 family | $8,000 family |
| Calendar Year Out-of-Pocket Maximums1 | |||
| Individual Coverage | $7,500 per person | $6,000 per person | $6,500 individual2 |
| Family Coverage | $15,000 family | $12,000 family | $13,000 family2 |
| What You Pay for In-Network Care | |||
| Wellness, Preventive Care & Labs | Eligible office visits, screenings, contraceptives, labs, and preventive medications are covered in full by all plans. | ||
| Primary Care Office Visit | $30 copay | $25 copay | 20% after deductible |
| Specialist Office Visit | $70 copay | $50 copay | 20% after deductible |
| Teladoc General Visit | $30 copay | $25 copay | $65 or less |
| Teladoc Dermatology Visit | $70 copay | $25 copay | $85 or less |
| Teladoc Therapist/Psychologist Visit | $70 copay | $50 copay | $90 or less |
| Teladoc Psychiatrist Visit | $70 copay | $50 copay | $220 or less initial visit; $100 or less ongoing visit |
| Urgent Care | 20% after deductible | $60 copay | 20% after deductible |
| Emergency Room | 20% after deductible | $350 copay | $300 copay after deductible |
| Most Other Services | 20% after deductible | 20% after deductible | 20% after deductible |
| What You Pay for Pharmacy Services | |||
| Generic Prescription Drugs: 30-Day Supply | $10 copay | $10 copay | 20% after deductible |
| Preferred Brand Prescription Drugs: 30-Day Supply | 20% after deductible | $30 copay | 20% after deductible |
| Non-Preferred Brand Prescription Drugs: 30-Day Supply | 40% after deductible | $50 copay | 40% after deductible |
| Generic Maintenance Medications: 90-Day Supply | $10 copay | $25 copay | 20% after deductible |
| Preferred Brand Maintenance Medications: 90-Day Supply | 20% after deductible | $75 copay | 20% after deductible |
| Non-Preferred Brand Maintenance Medications: 90-Day Supply | 40% after deductible | $125 copay | 40% after deductible |
2 For family coverage, the Choice HSA calendar year out-of-pocket maximum is $10,600 per person with a $13,000 family maximum.
2026 Medical Plan Costs Per Paycheck
| Value PPO | Choice PPO | Choice HSA | |
|---|---|---|---|
| Annual salary less than $45,000 | |||
| You | $48.00 | $76.11 | $69.19 |
| You + Spouse | $120.36 | $183.67 | $166.98 |
| You + Child(ren) | $97.44 | $151.48 | $137.71 |
| Family | $164.87 | $251.28 | $228.43 |
| Annual salary $45,000 to $150,000 | |||
| You | $78.67 | $110.94 | $100.86 |
| You + Spouse | $193.95 | $267.04 | $242.76 |
| You + Child(ren) | $157.01 | $219.09 | $199.17 |
| Family | $266.61 | $366.49 | $333.18 |
| Annual salary more than $150,000 | |||
| You | $87.23 | $121.46 | $110.42 |
| You + Spouse | $214.78 | $292.38 | $265.80 |
| You + Child(ren) | $174.00 | $239.88 | $218.07 |
| Family | $295.23 | $401.28 | $364.80 |
Deductible
This is the amount you must pay for your eligible medical and prescription drug claims before your health plan starts to share in the cost. If you receive non-covered services (such as cosmetic surgery), or are balance billed by an out-of-network provider, these expenses will not count toward your deductible.
For information about aggregate vs. embedded deductibles, please refer to this document: Deductible Differences Explained.
Coinsurance
It is a percentage amount that you are responsible for paying after you have met your deductible but before you have met your out-of-pocket maximum. This is when the plan starts to share in the cost of eligible claims.
Out-of-Pocket Maximum
The out-of-pocket maximum is the maximum amount you are responsible to pay for eligible, covered expenses during a calendar year. If you receive non-covered services (such as cosmetic surgery), or are balance billed by an out-of-network provider, these expenses will not count toward your out-of-pocket maximum.
Medical Insurance
Benefits-eligible Team Members have a choice of four medical insurance plans administered by Blue Cross and Blue Shield of Florida (BCBSFL).
Get Started
- First, use the information below to compare the coverage offered and what you would pay for each plan.
- Then, learn how to choose and use your plan and your health savings or reimbursement account (HSA or HRA).
- Once you’re a member, activate your account in My Health Toolkit to take advantage of services, programs, and resources from BCBSFL.
Helpful Terms & Definitions
Deductible
This is the amount you must pay for your eligible medical and prescription drug claims before your health plan starts to share in the cost. If you receive non-covered services (such as cosmetic surgery), or are balance billed by an out-of-network provider, these expenses will not count toward your deductible.
Coinsurance
It is a percentage amount that you are responsible for paying after you have met your deductible but before you have met your out-of-pocket maximum. This is when the plan starts to share in the cost of eligible claims.
Out-of-Pocket Maximum
The out-of-pocket maximum is the maximum amount you are responsible to pay for eligible, covered expenses during a calendar year. If you receive non-covered services (such as cosmetic surgery), or are balance billed by an out-of-network provider, these expenses will not count toward your out-of-pocket maximum.
Blue Cross & Blue Shield of Florida (BCBSFL)
Medical
Contact Information
Medical: 1-833-578-1132
Quit for Life: 1-866-784-8454
Plan Information
For the 2025 plan year, there are two new BCBSFL medical plan options for you to choose from – the Value PPO and the Choice PPO – in addition to the existing Choice HSA medical plan.
The existing Value HRA, Choice HRA, and Value HSA medical plans will be frozen to new participants and no longer offered after 2025. If you are currently enrolled in one of these three plans you can keep your current plan for one more year, or you may change your election to the new Value or Choice PPO or the Choice HSA plan.
- Under all BCBSFL medical plans, you can see any doctor (including specialists) or use any hospital in the network: no referrals are required and you don’t need to choose a primary care physician (PCP).
- When you receive care outside of the network, you are covered by insurance, but your costs will be higher.
- Preventive care is covered 100% with in-network providers.
Some plan highlights are outlined below. Make sure to review the updated plan comparison and biweekly rates in the next section for detailed cost and coverage information.
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Value PPO & Choice PPO
We are adding two new medical plan options that have set copays for office visits and some prescription drugs: the Value PPO plan and the Choice PPO plan.
Who can enroll? All benefits-eligible employees will be able to enroll.
Deductibles:
-
The Value PPO plan has a $6,550 deductible for individual coverage or a $13,100 deductible for family coverage.
-
The Choice PPO plan has a $2,500 deductible per person with a $5,000 family maximum.
FSAs and HSAs: If you choose the Value PPO plan or the Choice PPO plan, you will be able to set aside pretax dollars in the Health Care Flexible Spending Account (FSA) to help pay for eligible expenses.
What you’ll pay: Your per-paycheck deduction will depend on your salary and the medical plan you choose.
Choice HSA
In addition to the new Value PPO and Choice PPO plans, you’ll have the option to enroll the existing Choice HSA plan.
Who can enroll? All benefits-eligible employees will be able to enroll.
Deductible: The Choice HSA plan has a $2,500 deductible for individual coverage or a $5,000 deductible for family coverage.
FSAs and HSAs: The Choice HSA plan still has a Health Savings Account (HSA) available.
What you’ll pay: Your per-paycheck deduction will depend on your salary and the medical plan you choose.
Value HRA, Choice HRA & Value HSA
The existing Value HRA, Choice HRA, and Value HSA plans will be frozen to new participants and no longer offered after 2025.
Who can enroll: If you are currently enrolled in one of these plans, you can choose to stay in your current plan for one more year. If you want to change your plan, you can choose the Value PPO, Choice PPO, or Choice HSA.
What you’ll pay: Your per-paycheck deduction will depend on your salary and the medical plan you choose.
Using your existing HRA funds:
- If you are currently enrolled in the Value HRA or the Choice HRA, you’ll have until the end of 2025 to spend any funds that remain in your HRA.
- Your HRA funds will no longer be available after Dec. 31, 2025.
- No new contributions will be made to your HRA in 2025.
- You can check your HRA balance by logging in to your account with Accrue Health.
2025 Medical Plan Coverage Comparison
| New Value PPO | New Choice PPO | Choice HSA | Value HRA2 | Choice HRA2 | Value HSA2 | |
|---|---|---|---|---|---|---|
| Calendar Year Deductibles1 | ||||||
| Individual Coverage | $6,550 per person | $2,500 per person | $2,500 individual | $6,550 per person | $4,300 per person | $4,300 individual |
| Family Coverage | $13,100 family max | $5,000 family max | $5,000 family | $13,100 family max | $8,600 family max | $8,600 family |
| Calendar Year Out-of-Pocket Maximums1 | ||||||
| Individual Coverage | $7,500 per person | $5,000 per person | $5,000 individual | $6,550 per person | $6,300 per person | $6,500 individual |
| Family Coverage | $15,000 family max | $10,000 family max | $8,200 family | $13,100 family max | $9,000 family max | $9,000 family |
| What You Pay for In-Network Care | ||||||
| Wellness, Preventive Care & Labs | Eligible office visits, screenings, contraceptives, labs, and preventive medications are covered in full by all plans. | |||||
| Primary Care Office Visit | $30 copay | $25 copay | 20% after deductible | 0% after deductible | 30% after deductible | 20% after deductible |
| Specialist Office Visit | $70 copay | $50 copay | 20% after deductible | 0% after deductible | 30% after deductible | 20% after deductible |
| Teladoc General Visit | $30 copay | $25 copay | $55 or less | $55 or less | $55 or less | $55 or less |
| Teladoc Dermatology Visit | $70 copay | $25 copay | $85 or less | $85 or less | $85 or less | $85 or less |
| Teladoc Therapist/ Psychologist Visit | $70 copay | $50 copay | $90 or less | $90 or less | $90 or less | $90 or less |
| Teladoc Psychiatrist Visit | $70 copay | $50 copay | $220 or less initial visit; $100 or less ongoing visit | $220 or less initial visit; $100 or less ongoing visit | $220 or less initial visit; $100 or less ongoing visit | $220 or less initial visit; $100 or less ongoing visit |
| Urgent Care | 20% after deductible | $60 copay | 20% after deductible | 0% after deductible | 30% after deductible | 20% after deductible |
| Emergency Room | 20% after deductible | $350 copay | $300 copay after deductible | 0% after deductible | $300 copay after deductible | $300 copay after deductible |
| Most Other Services | 20% after deductible | 20% after deductible | 20% after deductible | 0% after deductible | 30% after deductible | 20% after deductible |
| What You Pay for Pharmacy Services | ||||||
| Generic Prescription Drugs: 30-Day Supply | $10 copay | $10 copay | 20% after deductible | 0% after deductible | 20% after deductible | 20% after deductible |
| Preferred Brand Prescription Drugs: 30-Day Supply | 20% after deductible | $30 copay | 20% after deductible | 0% after deductible | 20% after deductible | 20% after deductible |
| Non-Preferred Brand Prescription Drugs: 30-Day Supply | 40% after deductible | $50 copay | 40% after deductible | 0% after deductible | 40% after deductible | 40% after deductible |
| Generic Maintenance Medications: 90-Day Supply | $10 copay | $25 copay | 20% after deductible | 0% after deductible | 20% after deductible | 20% after deductible |
| Preferred Brand Maintenance Medications: 90-Day Supply | 20% after deductible | $75 copay | 20% after deductible | 0% after deductible | 20% after deductible | 20% after deductible |
| Non-Preferred Brand Maintenance Medications: 90-Day Supply | 40% after deductible | $125 copay | 40% after deductible | 0% after deductible | 40% after deductible | 40% after deductible |
2The Value HRA, Choice HRA, and Value HSA plans will be discontinued after 2025. Any remaining HRA account balances will be forfeited. No new enrollments will be accepted into the Value HRA, Choice HRA and Value HSA plans for the 2025 plan year."
2025 Medical Plan Costs Per Paycheck
| New Value PPO | New Choice PPO | Choice HSA | Value HRA | Choice HRA | Value HSA | |
|---|---|---|---|---|---|---|
| Annual salary less than $45,000 | ||||||
| You | $45.29 | $71.81 | $65.28 | $45.29 | $45.90 | $54.39 |
| You + Spouse | $113.56 | $173.29 | $157.54 | $113.56 | $114.89 | $133.58 |
| You + Child(ren) | $91.94 | $142.92 | $129.93 | $91.94 | $93.09 | $109.23 |
| Family | $155.55 | $237.07 | $215.52 | $155.55 | $157.37 | $182.86 |
| Annual salary $45,000 to $150,000 | ||||||
| You | $70.88 | $99.96 | $90.88 | $70.88 | $71.49 | $79.99 |
| You + Spouse | $174.74 | $240.59 | $218.72 | $174.74 | $176.08 | $194.77 |
| You + Child(ren) | $141.46 | $197.39 | $179.45 | $141.46 | $142.61 | $158.76 |
| Family | $240.20 | $330.20 | $300.18 | $240.20 | $242.03 | $267.52 |
| Annual salary more than $150,000 | ||||||
| You | $75.21 | $104.72 | $95.20 | $75.21 | $75.81 | $84.31 |
| You + Spouse | $185.17 | $252.07 | $229.15 | $185.17 | $186.50 | $205.20 |
| You + Child(ren) | $150.02 | $206.81 | $188.01 | $150.02 | $151.17 | $167.32 |
| Family | $254.53 | $345.95 | $314.50 | $254.53 | $256.35 | $281.84 |
My Health Toolkit
After you’ve enrolled in a BCBSFL medical plan, your My Health Toolkit account so that you have easy access to your member ID card, plan coverage details, in-network care locator, and claims.
Find an In-Network Doctor
You can use the Find Care section of your My Health Toolkit account to find a provider that is covered by your plan.