Designed with the Highest Value; All Services Provided by the GatorCare Network
The majority of services received under the Prime plan fall into Tier 1 benefits provided by the GatorCare Network. This includes hospitals, physicians and providers in Gainesville and Jacksonville, and emergency care for you and your covered dependents. Physician office visits require co-payments; other services require paying deductibles and co-insurance. Wellness and preventive care and annual physicals are offered with no out-of-pocket expense to you.
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?
2023 Benefits
Benefit Booklet
2023 Prime Benefit Booklet
This booklet describes your coverage, benefits, limitations and exclusions for the self-funded Group Health Benefit Plan Prime 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 cost 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.
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.
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.
Infertility Benefits
Benefit descriptions
GatorCare Infertility Benefits
Below is a document that details eligibility, diagnoses, treatment, and coverage for Prime plan members.
FAQs
Infertility Benefits FAQs
Below is a list of frequently asked questions for infertility benefits and coverage for Prime plan members.
Providers
UF Health Reproductive Medicine Providers
Below is a list of UF Health Reproductive Medicine providers that provide Tier 1 coverage for Prime plan members.
Coming in 2024
2024 Health Plan Benefits Document
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?
2024 Summary of Benefits & Coverage (PHARMACY)
The SBC shows how you and the plan would share the costs for covered pharmacy services.
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