Medical
Low HMO Health Plan

IMPORTANT NOTE

This is an open access plan that requires you to choose a primary care physician. For details on how to find out if your medical provider – primary care provider, or specialist is considered In-Network for the Low and High HMO plans without logging into your account, click here.

Highlights

Health Transparency Machine-Readable Files:

www.floridablue.com/members/tools-resources/transparency
This link leads to the machine-readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.

HMO Network within Florida Blue

The HMO network within Florida Blue provides access to Mayo Hospital, but this does not include primary care doctors or nurses. The HMO network covers facilities such as hospitals and ER visits, and specialists only. Please verify with your doctors in advance before making your benefit selections as a new hire.
When selecting either the Low HMO or High HMO medical plans, you will need to choose your primary care provider during the enrollment session. If you do not, an in-network provider will be assigned to you.
This plan does not allow for out-of-network or out-of-state services. The HMO network within Florida Blue is subject to change.
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How It Works

This is an open access plan that requires you to choose a primary care physician. As long as you reside in the State of Florida, you may choose a participating network physician of your choice. In order to receive coverage you must utilize HMO providers that participate with Florida Blue, BlueCareHMO. Providers can be found at www.floridablue.com.

Plan Details Include:

  • Your School District continues to provide employee medical coverage at no premium cost to you
  • Your School District continues to offset a portion of the dependent coverage cost
  • Coinsurance applies to all services that do not have set copays
  • You must remain in network for services to be covered. Outside the state of Florida only emergency care is covered
  • Deductible, coinsurance and copays (including Rx), count toward the maximum out-of-pocket limit
  • Medical Flexible Spending Account available (Employee Contributions Only)
  • PayFlex Card accounts will not roll over the amount elected in the prior plan year
  • As a Florida Blue HMO member, you and your covered dependents have coverage for certain services when you’re away from home. Florida Blue HMO offers separate programs for short trips and long-term stays.Visit this link for more information

Note: If you wish to contribute to the Medical FSA, you must make that election at your enrollment session. Prior year contributions are not going to automatically roll over.

 

How to Find a Primary Care Provider (PCP)

Please follow the instructions below to search for In-Network Providers:

  1. www.FloridaBlue.com
  2. Click on “Find Care”
  3. Click on “Find a doctor”
  4. Go to the section “Find Doctors by Plan”
  5. Click the select “drop-down”
  6. Under Health Plans select BlueCare (HMO)
  7. Click Continue
  8. Enter the “Last Name” of the provider and/or select “Type of Provider”
  9. Search within your mile radius, using the drop-down (5,10, 20)
  10. Enter your zip code
  11. Click Search Now

HMO Plan Bi-Weekly Contribution Rates

PER PAY EMPLOYEE DEDUCTIONS 20 PAY 24. PAY
Employee Only $0.00 $0.00
Employee & Spouse $259.91 $216.59
Employee & Child(ren) $186.66 $155.55
Employee & Family $509.80 $424.83

 

 

Sanitas

Florida Blue and Sanitas Medical Centers deliver integrated, accessible primary care in one place—offering services like urgent care, mental health, diagnostics, wellness, and insurance support. With both in-person and 24/7 virtual access, these Value Choice Providers aim to simplify and lower the cost of high-quality healthcare for Florida Blue members.
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Get the App

Access your insurance and the tools to help you use it anytime, anywhere with the mobile app.

To view all plans and compare see complete chart below.

How to Enroll:

You can enroll in this benefit by visiting www.myfbmc.com, logging in and following the instructions to access the benefit. Remember you must create an account if you have not already in order to enroll in benefits.

For Summary Plan Descriptions and Medical Plan Documents, please click here.

  • You must re-enroll and select your Medical FSA and Dependent Care accounts each year. These will not automatically roll over

  • ID Cards – You can print a temporary Florida Blue ID card or request a new member ID card by visiting www.floridablue.com
  • Blue365 offers member discounts on Gym memberships and Lasik at LasikPlus Centers. Call 1-855-511-2583. To access Blue365, logon to: www.floridablue.com