Designed with Flexibility in Mind, Offering Three Tiers of Benefit Coverage
The Premium plan offers you 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.
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
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 TestS 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.
Diabetes Medication 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
2023 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.
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.
2023 Summary of Benefits & Coverage (MEDICAL)
The SBC shows how you and the plan would share the cost for covered health care services.
2023 Summary of Benefits & Coverage (PHARMACY)
The SBC shows how you and the plan would share the costs for covered pharmacy services.
GatorCare Infertility Benefits
Below is a document that details eligibility, diagnoses, treatment, and coverage for Premium plan members.
Infertility Benefits FAQs
Below is a list of frequently asked questions for infertility benefits and coverage for Premium plan members.
UF Health Reproductive Medicine Providers
Below is a list of UF Health Reproductive Medicine providers that provide Tier 1 coverage for Premium plan 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.
Contact your dedicated Florida Blue representative
- (352) 594-3354
- Jacksonville & Central Florida
- (904) 244-9130