Monthly premium
The Access (HMO-POS) plan offers a more affordable range of benefits as well as a $0 premium* for those who qualify for Extra Help (Low-Income Subsidy). The plan also includes helpful benefits like:
- A monthly allowance for groceries** and everyday health items
- $0 rides to appointments
- Low copays for prescription drugs
Our wide network includes 12,000 providers and all Rhode Island hospitals, making it easier to get the care you need without traveling far.
*You must qualify for the Low-Income Subsidy (LIS) program, also known as Extra Help, to receive the $0 premium.
Not sure what plan you need? Use the plan recommendation tool.
Medical
- $0 monthly premium*
- $0 primary care visits
- $0-$35 specialist visits
- $0 labs
- $25 X-rays
- $0-$35 physical/speech/occupational therapy
- Out-of-network coverage
Prescription Drugs*
- $0 pharmacy deductible
- Low copays on prescription drugs
Dental/Vision/Hearing
- $1,500/year dental benefit maximum
- $0 cost preventive and comprehensive dental
- No coverage for crowns
- $0 cost annual vision exam
- $200/year eyewear allowance
- $0 cost annual hearing exam
- Hearing aid coverage starting at $200 per ear
Extras
- $0 access to select fitness centers across the state
- $0 rides (12 one-way rides)
- Get $50/month to spend on groceries** and over-the-counter (OTC) everyday health items
Qualify for Medicare + Medicaid?
See if your doctor is in the network
Ambulance
$200 copay per trip
Dental Services
Medicare-covered
In-network: 20% of the cost
Out-of-network: 20% of the cost
Preventive: $0
Comprehensive: $0
$1,500 limit on all covered dental services for preventive and comprehensive dental services. All preventive and comprehensive services must be provided by an in-network plan-contracted dentist.
Diabetes Supplies and Services
In-network: $0
You must use Abbott plan-designated monitors and test strips.
Diagnostic Tests, Lab and Radiology Services, and X-rays
In-network
$0 for lab services
$25 for X-rays
$50 for diagnostic tests
$0-$150 for high-tech radiology services (like MRIs)
Out-of-network
20% of the cost
Emergency Care
$130 copay per visit
If you are admitted to the hospital within 24 hours, you do not have to pay your share of the cost for emergency care.
Hearing Services
Routine hearing
In-network: $0
Out-of-network: 20% of the cost
Non-routine hearing
In-network: $35 copay per visit
Out-of-network: 20% of the cost
Hearing aids
$200-$1,675 copay per hearing aid (2 aids every year)
Outpatient Hospital/Surgery
In-network:
Up to $300 copay per visit for ambulatory surgical center based services.
Up to $400 copay per visit for hospital based services.
Out-of-network:
20% of the cost
Primary Care Provider Visit
In-network
$0 PCP copay per visit
Out-of-network
20% of the cost
Specialist Visit
In-network: $0-$35 copay per visit
Out-of-network: 20% of the cost
Referral is required for specialist visits.
Vision Visit
Routine vision
In-network: $0
Out-of-network: 20% of the cost
Non-routine vision
In-network: $35 copay per visit
Out-of-network: 20% of the cost
Vision Hardware
Our plan offers a $200/year allowance for vision hardware.
Preventive Care
In-network: $0
Out-of-network: 20% of the cost
Inpatient Hospital Care
In-network
$400 copay per day for days 1-6
$0 Days 7+
Out-of-network
20% of the cost
Our plan covers an unlimited number of days for an in-network inpatient hospital stay.
Skilled Nursing Facility (SNF)
In-network
$0 copay per day for days 1-20
$218 copay per day for days 21-45
$0 copay per day for days 46-100
Out-of-network
20% of the cost
Our plan covers up to 100 days in a SNF.
Preferred Mail Order (100-day Supply)
No deductible+
Tier 1 (Preferred Generic)
$0-$12.65 copay+
$0-$12.65 copay+
Tier 2 (Non-preferred Generic)
$0-$12.65 copay+
$0-$12.65 copay+
Tier 3 (Preferred Brand)
$0-$12.65 copay+
$0-$12.65 copay+
Tier 4 (Non-Preferred Drug)
$0-$12.65 copay+
$0-$12.65 copay+
Tier 5 (Specialty Tier)
$0-$12.65 copay+
N/A
Insulins (30-day supply)
$0-$12.65 copay+
$0-$12.65 copay+
*You must qualify for the Low-Income Subsidy (LIS) program, also known as Extra Help, to receive the $0 premium.
**You may be eligible for the monthly grocery benefit, which is part of Special Supplemental Benefits (SSBCI) if you are living with one or more qualifying chronic condition(s), as defined by CMS, including but not limited to chronic heart failure, chronic lung diseases, dementia, diabetes mellitus, and frailty & fall risk, and receive a Low-Income Subsidy (also called Extra Help). Receiving this benefit is not solely determined by your condition(s); all relevant eligibility criteria must be satisfied before benefit is available for use. Please see your Evidence of Coverage for full details.
+ Based on receiving Low Income Subsidies (LIS). If you lose your Low Income Subsidies (LIS), you will be required to pay copayments and coinsurance.
1The out-of-pocket maximum includes only Medicare-covered services. This is the most a member would pay for these services during a calendar year. You must receive all routine care from plan providers unless you select the BlueCHiP for Medicare Essential (HMO-POS), BlueCHiP for Medicare Enhanced (HMO-POS) BlueCHiP for Medicare Extra (HMO-POS), or the BlueCHiP for Medicare Access (HMO-POS) plan. If you select the BlueCHiP for Medicare Essential (HMO-POS), BlueCHiP for Medicare Enhanced (HMO-POS), BlueCHiP for Medicare Extra (HMO-POS), or the BlueCHiP for Medicare Access (HMO-POS) plan, with the exception of emergency or urgent care, ambulance, or dialysis services, it may cost more to get care from out-of-network providers.
2A preauthorization may be required. Review may include but is not limited to pre-authorization and/or continued treatment by the plan and/or plan designee. Contact Plan for details.
3You must use network pharmacies to access your prescription drug benefit, except under non-routine circumstances, quantity limitations and restrictions may apply. Please refer to the Summary of Benefits or the Evidence of Coverage for prescription drug cost share information in a long-term care setting, mail order and extended day retail supplies as well as detailed benefit information concerning the Initial Coverage stage and the Catastrophic level stage.