The Premium plan offers 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.
Here we have answers to questions like: How much do I pay per visit? What's my deductible? How much is covered at the pharmacy?
New in 2023
Egg freezing services offered by Tier 1 UF Health Reproductive Medicine physicians at Springhill Reproductive Endocrinology Institute are now covered by GatorCare.
Tier 1 Urgent Care Centers are being updated to accurately reflect current locations and rates.
All members are eligible to receive free Contour® and Contour® Next test strips at a Tier 0 level of coverage.
The Value Max Copay Assistance Program is being expanded to cover diabetes medications. To view all affected medications, click the link below.
2023 Benefit Resources
This booklet describes your coverage, benefits, limitations and exclusions for the self-funded Group Health Benefit Premium Plan established and
maintained by GatorCare.
This Schedule of Benefits is part of your Benefit Booklet, where more detailed information about your
benefits can be found.
The SBC shows how you and the plan would share the cost for covered health care services.
The SBC shows how you and the plan would share the costs for covered pharmacy services.
Below is a document that details eligibility, diagnoses, treatment, and coverage for Premium plan members.
Below is a list of frequently asked questions for infertility benefits and coverage for Premium plan members.
Below is a list of UF Health Reproductive Medicine providers that provide Tier 1 coverage for Premium plan members.
Coming in 2024
Here we have answers to questions like: How much do I pay per visit? What’s my deductible? How much is covered at the pharmacy?
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.
Contact Your Dedicated Florida Blue Representative
- (352) 594-3354
- Jacksonville & Central Florida
- (904) 244-9130