Simply Blue and Health Check Basic
Are you looking for a great value and affordable premiums in your health insurance coverage? Creating value is what Blue Cross and Blue Shield of Oklahoma (BCBSOK) is all about. And, with the Simply Blue plan, you get dependable coverage at a lower monthly premium. In fact, Simply Blue is the most affordable plan we offer.
Some common health care expenses covered under this plan include:
- Inpatient and outpatient medical, surgical and hospital services
- Diagnostic services
- Prescription drug coverage
- Office visits
- Emergency care
- Rehabilitation care
- Childhood immunizations through age 18
- Therapy services, including physical and occupational
Simply Blue may be right for your if you are an individual or family who:
- Is looking for dependable health care coverage at the lowest monthly premium
- Is comfortable with a higher deductible
- Wants the security of being covered
- Would like a lower premium for using generic drugs
- Is comfortable paying full price for brand name drugs
For more information on Simply Blue and other available plans, view this Product Guide .
Health insurance costs include monthly payments, individual deductibles, drug coverage deductibles, out-of-pocket expenses, copayments, and coinsurance. For the Simply Blue plan, here's what you can expect:
- Deductibles ranging from $1,000 to $10,000
- Copayment of $40 for most office visits
- Inpatient deductible of $500 applies for each occurrence
- Outpatient deductible of $200 applies for each occurrence
- Emergency room deductible of $200 applies for each occurrence; this deductible is waived if admitted to hospital.
- To view your specific costs, view pricing.
Enjoy prescription drug coverage that begins immediately after joining BCBSOK, and most office visit copayments are $40. Plus you gain access to a large network of contracted providers with deductibles as low as $1,000. Other key features and benefits of included with this plan are:
- Broad network of contracting doctors, hospitals and health care providers in more than 50 states and 200 countries
- Simply Blue pays from 70% for most in-network provider services and 50% for most out-of-network provider services
- Prescription drug coverage begins immediately at 50% of allowable charges when you use an in-network pharmacy
- Benefits for preventive care services covered
- No lifetime maximum
- Access to Blue Care Connection®, a series of services and programs geared towards improving your health
- Benefits are subject to pre-existing condition limitations for covered individuals age 19 and over only
- No benefits will be provided for pre-existing conditions for a period of 12 months after coverage becomes effective. This applies to covered individuals age 19 and over only.
- This provision applies to any condition or any charges relating to a condition existing during the 12 months immediately before the effective date of coverage.
There are a couple of ways that you can customize your Simply Blue plan, including certain types of add-on coverage and insurance. The following options are available for this plan.
BlueCare Dental PPO can be added for a few more dollars a month. Key features of this plan include:
- Benefits effective immediately for check-ups, cleanings and other preventive services
- Deductible of $50 per member during benefit period; $150 maximum per family
- Maximum benefit of $1,500 per covered individual
- Plan pays 50 – 100 percent of allowable charges, depending on type of service, at participating dentists
- Plan pays 30 – 70 percent of allowable charges, depending on type of service, at out-of-network dentists
- To learn more about BlueCare Dental PPO, including costs, view the Enrollment Guide above.
- Generic Drugs — $10 copayment in network
- Preferred Brand Drugs — 50% coinsurance level in network
- Your benefit plan includes a mail service program that offers you the convenience of having covered maintenance medications delivered directly to you.
- Your out-of-pocket cost for prescription drugs usually is less when you choose generic or preferred .