BlueCHiP Direct Advance
4950/9900
This is the lowest-cost plan that Blue Cross offers in the Silver tier. Your primary care provider (PCP) coordinates your healthcare as well as referrals for other doctors and labs. This plan covers office visits and most generic drugs before the deductible. You have access to a tailored network of high-quality doctors, hospitals, and labs in Rhode Island.
- Full coverage for many preventive services, like an annual physical
- Free dental exam, cleaning and annual exam for members under 19
- MedsYourWay® prescription savings program—no coupons or discount cards needed—and all covered prescription purchases count toward your deductible*
- Earn up to $250 (both subscriber and spouse) in wellness rewards and also with Blue365, you get great discounts on gyms, nutrition services, fitness trackers, sneakers and much more
- $0 copays for programs on quitting smoking, weight loss, and managing conditions like diabetes
- This plan uses a limited RI network, which includes all Brown University Health hospitals, over 500 primary care providers, and over 1,800 specialty doctors.
Major RI hospitals:- Rhode Island Hospital
- Hasbro Children's
- The Miriam Hospital
- Newport Hospital
- Bradley Hospital
What's covered
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Coverage
In-Network You Pay
Medical Coverage
Preventive Services
$0
Primary Care Provider (PCP) Office Visit when affiliated with a Patient Centered Medical Home (PCMH)
$25
PCP not affiliated with a PCMH
$45
Doctors Online (Designated telemedicine provider)
$40
Retail Clinic
$50
Specialist Visit
$60
Acupuncture Treatment
$45 (12 visits per year)
Urgent Care Center
$75
Emergency Room
10% after deductible
Diagnostic Laboratory Tests
10% after deductible
X-rays
10% after deductible
High-End Radiology (i.e., MRI, PET, and CAT scans etc.)
10% after deductible
Inpatient Hospital
10% after deductible
Pediatric Vision Eyeware (Dependents under 19)
Collection prescription glasses, lenses, and collection contact lenses
10% after deductible
Pediatric Dental (Dependent under 19)
Oral exams, cleanings, x-rays, fluoride treatments, sealants and space maintainers
$0
All other covered dental services
50% after deductible
Coverage
In-Network You Pay
Tier 1 (Preferred Generic)
$7
Tier 2 (Non-preferred Generic)
$35
Tier 3 (Preferred Brand)
$50 after deductible
Tier 4 (Non-Preferred Brand)
$75 after deductible
Tier 5 (Specialty)
$150 after deductible
*MedsYourWay is not insurance. It is a drug discount program administered by Prime Therapeutics, LLC, an independent company contracted by BCBSRI to provide pharmacy benefit management services. Ask your pharmacy if they participate in MedsYourWay before filling your prescription.