Designed With Flexibility in Mind, Offering Three Tiers of Benefit Coverage
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.
2025 Benefit Resources
Looking for a preview of next year?
Preview the 2025 Summary of Health Plan Benefits Document!
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.
2025 Summary of Benefits & Coverage (MEDICAL)
The SBC shows how you and the plan would share the costs for covered health care services.
2025 Summary of Benefits & Coverage (PHARMACY)
The SBC shows how you and the plan would share the costs for covered pharmacy services.
2025 Premium Benefit Booklet
This booklet describes your coverage, benefits, limitations and exclusions for the self-funded Group Health Benefit Premium Plan established and maintained by GatorCare.
2025 Schedule of Benefits (CYD’s & OOP’s)
This Schedule of Benefits is part of your Benefit Booklet, where more detailed information about your benefits can be found.
2025 General Wellness Guidelines
Not sure what exams and screenings to do to keep yourself well? Check out the General Wellness Guidelines below for an in-depth look at the recommended doctor visits you should do this year!
Additional Benefit Resources
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 now covered by GatorCare.
Egg Freezing
Egg Freezing Eligibility Form
Egg freezing services offered by Tier 1 UF Health Reproductive Medicine physicians at Springhill Reproductive Endocrinology Institute are now covered by GatorCare.
Urgent Care Centers
Tier 1 Urgent Care Centers in Florida
Tier 1 Urgent Care Centers are being updated to accurately reflect current locations and rates.
Free Diabetes Test Strips
Tier 0 Contour® & Contour® Next Test Strips
All members are eligible to receive free Contour® and Contour® Next test strips at a Tier 0 level of coverage.
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.
Medical INformation Disclosure
Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Infertility Benefits
Benefit descriptions
GatorCare Infertility Benefits
Below is a document that details eligibility, diagnoses, treatment, and coverage for Premium plan members.
Infertility Eligibility
GatorCare Infertility Benefit Eligibility
Below is a document that details eligibility for Premium members.
FAQ
Infertility Benefits FAQ’s
Below is a list of frequently asked questions for infertility benefits and coverage for Premium plan members.
Providers
UF Health Reproductive Medicine Providers
Below is a list of UF Health Reproductive Medicine providers that provide Tier 1 coverage for Premium plan members.
Questions?
Contact Your Dedicated Florida Blue Representative
- Gainesville
- (352) 594-3354
GatorCareCSR@bcbsfl.com
- Jacksonville & Central Florida
- (904) 244-9130
GatorCareCSR@bcbsfl.com