Designed with flexibility in mind, offering three tiers of benefit coverage
The Premium plan offers you three network tier options. Tier 1 benefits are services you receive from the GatorCare Network, which includes hospitals, physicians and providers in Gainesville, Jacksonville and Central Florida. Tier 1 benefits offer the best value, with lower deductibles and out-of pocket costs. Tier 2 benefits apply when you receive services from the Florida Blue BlueOptions network, which typically result in higher out-of-pocket costs. When using Tiers 1 and 2 for wellness and preventive care, annual physicals and labs are offered with no out-of-pocket expense to you. Tier 3 benefits apply when you receive services from an out-of-network provider; you still have coverage, but may be billed for the difference between the provider’s charge and the allowed amount.
Overview and Benefits
OVERVIEW
Looking for an overview of the plan?
Here you can find general information about the plan and get a better idea of how our coverage works for you!
Looking for more specifics?
Check out our Summary of Health Plan Benefits!
Here we have answers to questions like: How much do I pay per visit? What’s my deductible? and How much is covered at the pharmacy?
Urgent Care Centers
New Tier 1 Urgent Care Centers in Florida 2023
Tier 1 UCC’s are being updated accurately reflect current locations and rates.
Infertility Benefits
Benefit descriptions
GatorCare Infertility Benefits
Below is a document that details eligibility, diagnoses, treatment, and coverage for Premium members.
FAQ
Infertility Benefits FAQ’s
Below is a list of frequently asked questions for infertility benefits and coverage for Premium members.
Providers
UF Health Reproductive Medicine Providers
Below is a list of UF Health Reproductive Medicine Providers that provide Tier 1 coverage for Premium Members.
2023 Additional Resources (Summary of Benefits and Coverage)
Benefit Booklet
2023 Premium Benefit Booklet [COMING SOON]
This booklet describes your coverage, benefits, limitations and exclusions for the self-funded Group Health Benefit Plan Premium Plan established and
maintained by GatorCare.
Schedule of Benefits
2023 Schedule of Benefits (CYD’s and OOP’s) [COMING SOON]
This Schedule of Benefits is part of your Benefit Booklet, where more detailed information about your
benefits can be found.
SBC Medical
2023 Summary of Benefits and Coverage (MEDICAL)
The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services.
SBC PHarmacy
2023 Schedule of Benefits and Coverage (PHARMACY)
This document details the Premium pharmacy coverage and benefits.
2022 Additional Resources
Benefit Booklet
2022 Premium Benefit Booklet
This booklet describes your coverage, benefits, limitations and exclusions for the self-funded Group Health Benefit Plan Premium Plan established and
maintained by GatorCare.
Schedule of Benefits
2022 Schedule of Benefits (CYD’s and OOP’s)
This Schedule of Benefits is part of your Benefit Booklet, where more detailed information about your
benefits can be found.
SBC Medical
2022 Summary of Benefits and Coverage (MEDICAL)
The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services.
SBC PHarmacy
2022 Schedule of Benefits and Coverage (PHARMACY)
This document details the Premium pharmacy coverage and benefits.
Coming in 2023
Egg Freezing
Elective Oocyte Cryopreservation (Egg Freezing)
Egg freezing services offered by Tier 1 UF Health Reproductive Medicine physicians at Springhill Reproductive Endocrinology Institute are covered by GatorCare.
Diabetes Medication Copay Assistance
Value Max Copay Assistance
The Value Max Copay Assistance Program is being expanded to cover diabetes medications. To view all affected medications, click the link below.
Free Diabetes Tests
Tier 0 Contour® and Contour® Next Test Strips
All members are eligible to receive free Contour® and Contour® Next Test strips at a tier 0 level of coverage.
URGENT CARE CENTERS
New Tier 1 Urgent Care Centers in Florida 2023
Tier 1 UCC’s are being updated accurately reflect current locations and rates.
Contact your dedicated Florida Blue representative
- Gainesville—(352) 594-3354
GatorCareCSR@bcbsfl.com - Jacksonville & Central Florida—(904) 244-9130
GatorCareCSR@bcbsfl.com
The following applies to the above plan:
As a result of the Affordable Care Act, GatorCare is required to provide employees with an easy-to-understand Summary of Benefits and Coverage (SBC) statement that describes the plan’s coverage. All insurance companies must use the same format allowing members to compare plan options. Please note that the examples on page 8 for medical and page 12 for pharmacy, do not reflect actual GatorCare co-pays and deductibles, rather they are general examples required by the federal government. To get your GatorCare medical specific cost of services, call (800) 664-5295; for Magellan Pharmacy Benefits, call (800) 651-8921.
For additional questions about enrollment or premiums, view the Enrollments section of the FAQ page or contact your Human Resources office.