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The BlueChoice HMO Plan

An HMO is a managed health care plan consisting of a network of physicians and other medical providers.

If you enroll in the BlueChoice HMO Plan, all of you health care must be coordinated and approved by your HMO's primary care physician and received in-network.

Here are some of the features of the BlueChoice HMP Plan:

  You Pay...
Annual Deductible None
Physician services (office visits) $10 co-payment
Physician services (inpatient) None
Physical exams (routine adult) $10 co-payment for PCP
$20 co-payment for specialist
Specialist care (office visits) $20 co-payment
Ambulance None

Prescription Drug Benefits
Retail Copay 30 - day Supply Mail Order Copay 90-day supply
Generic $10 $20
Formulary Brand $20 $40
Non - Formulary Brand $35 $70

Annual Maximum Benefit None
Annual Out-of-Pocket Maximum None


For a complete look at the features and benefits of all three Options under the BlueChoice HMO Plan, be sure to visit the Health Plan Comparison Chart.