Designed With Two Network Options & Two Tiers of Benefit Coverage
The highest value for the Prime Plus plan is received when using the Tier 1 benefits provided by the GatorCare Network, which includes hospitals, physicians and providers in Gainesville, Jacksonville, and Central Florida. When using the Tier 1 GatorCare Network for wellness and preventive care, annual physicals and labs are offered with no out-of-pocket expense to you. The Prime Plus plan also offers Tier 2 benefits, which apply when you receive services from Florida Blue’s BlueOptions providers. It is important to review the schedule of benefits, as utilizing Tier 2 benefits typically results in higher out-of-pocket costs.
LOOKING FOR MORE SPECIFICS?
Check Out the 2023 Summary of Health Plan Benefits!
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
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.
Urgent Care Centers
New Tier 1 Urgent Care Centers in Florida 2023
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.
2023 Benefit Resources
Benefit Booklet
2023 Prime Plus Benefit Booklet
This booklet describes your coverage, benefits, limitations and exclusions for the self-funded Group Health Benefit Prime Plus Plan established and
maintained by GatorCare.
Schedule of Benefits
2023 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.
SBC Medical
2023 Summary of Benefits & Coverage (MEDICAL)
The SBC shows how you and the plan would share the costs for covered health care services.
SBC PHarmacy
2023 Summary of Benefits & Coverage (PHARMACY)
The SBC shows how you and the plan would share the costs for covered pharmacy services.
Infertility Benefits
Benefit descriptions
GatorCare Infertility Benefits
Below is a document that details eligibility, diagnoses, treatment, and coverage for Prime Plus members.
FAQ
Infertility Benefits FAQ’s
Below is a list of frequently asked questions for infertility benefits and coverage for Prime Plus members.
Providers
UF Health Reproductive Medicine Providers
Below is a list of UF Health Reproductive Medicine providers that provide Tier 1 coverage for Prime Plus members.
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.
Questions?
Contact Your Dedicated Florida Blue Representative
- Gainesville
- (352) 594-3354
GatorCareCSR@bcbsfl.com
- Jacksonville & Central Florida
- (904) 244-9130
GatorCareCSR@bcbsfl.com