Designed with flexibility in mind, offering three tiers of benefit coverage
The Premium Plus plan offers you three network tier options. Tier 1 benefits are services you receive from the GatorCare Network. Tier 1 is primarily composed of UF Health facilities and physicians in Central Florida, Gainesville, and Jacksonville, however, select community providers are included to ensure adequate access to care. Tier 1 benefits offer the best value, with lower copays, deductibles and out of pocket costs. Tier 2 benefits apply when you receive services from Florida Blue’s BlueOptions providers, 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.
2024 Benefit Resources
LOOKING FOR MORE SPECIFICS?
Check Out the 2024 Summary of Health Plan Benefits!
The Premium Plus plan offers you three network tier options. Tier 1 benefits are services you receive from the GatorCare Network. Tier 1 is primarily composed of UF Health facilities and physicians in Central Florida, Gainesville, and Jacksonville, however, select community providers are included to ensure adequate access to care. Tier 1 benefits offer the best value, with lower copays, deductibles and out of pocket costs. Tier 2 benefits apply when you receive services from Florida Blue’s BlueOptions providers, 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.
2024 Summary of Benefits and Coverage (MEDICAL)
The SBC shows how you and the plan would share the cost for covered health care services.
2024 Schedule of Benefits and Coverage (PHARMACY)
The SBC shows how you and the plan would share the costs for covered pharmacy services.
2024 Premium Plus Benefit Booklet
This booklet describes your coverage, benefits, limitations and exclusions for the self-funded Group Health Benefit Premium Plus Plan established and maintained by GatorCare.
2024 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.
2024 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!
Intertility 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.
Benefit descriptions
GatorCare Infertility Benefits
Below is a document that details eligibility, diagnoses, treatment, and coverage for Premium Plus members.
FAQ
Infertility Benefits FAQ’s
Below is a list of frequently asked questions for infertility benefits and coverage for Premium Plus members.
Providers
UF Health Reproductive Medicine Providers
Below is a list of UF Health Reproductive Medicine providers that provide Tier 1 coverage for GatorCare members.
Additional Benefit Resources
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.
URGENT CARE CENTERS
Tier 1 Urgent Care Centers in Florida
Tier 1 UCC’s are being updated accurately reflect current locations and rates.
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.
Contact your dedicated Florida Blue representative
- Gainesville—(352) 594-3354
GatorCareCSR@bcbsfl.com - Jacksonville & Central Florida—(904) 244-9130
GatorCareCSR@bcbsfl.com
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.