Blue Cross and Blue Shield of RI

(401) 459-5550, or 1-855-690-2583 (my0blue)

Monday - Friday, from 8:00 a.m. - 5:00 p.m.

Blue Cross and Blue Shield of RI

Medical Plan

Getting coverage is fast and easy. Add a medical plan today!

First, let’s make sure you’re in the right place.

Please read the four statements below. If any of them cover your situation, click “yes” and we’ll send you to the enrollment form. If none of them apply to you, click “no” and you can continue with the plan change form.

  • I want to add medical or dental coverage to my existing plan.
  • I need to add or remove dependents from my current plan.
  • I enrolled through HealthSource RI.
  • I am a dependent on someone else's plan, but now I need my own.

Who will be covered

Monthly Premium


Dental Plan

Getting coverage is fast and easy. Add a dental plan today!

Who will be covered

Monthly Premium


Effective Date

01/01/2018

Monthly Premium

New to Blue? Just changing your current plan? Enter some basic information so we can provide you with a quote.

I would like coverage for . I am . interested in plans. want to (edit)

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Find Plans for Me

2017

Gold

2017 BlueSolutions for HSA Direct 1400/2800

This plan offers a high level of coverage once you meet your deductible with the added benefit of an optional health savings account to pay for medical expenses. You’ll have access to our national network of doctors (across all 50 states), labs, and hospitals.

  • Full coverage for many preventive services, like an annual physical
  • You receive tax advantages when you open a health savings account
  • Includes dental and vision coverage for dependents under the age of 19
  • $0 copayments for programs on quitting smoking, and managing conditions like asthma and diabetes
  • Earn up to $250 (both subscriber and covered spouse) in wellness rewards and receive a 20% discount on CVS branded health items
  • 24/7 phone access to care through the Nurse Care Line
  • View benefit information on Your Blue Touch RI mobile app

Who will be covered

Selecting this plan will add coverage for .


BlueSolutions for HSA Direct 1400/2800

Monthly Premium

Get Quote

309.53
BlueSolutions for HSA Direct 1400/2800
medical
2017
3
shop-for-plan/2017/bluesolutions-for-hsa-direct-14002800

Individual

Deductible

$1,400

Max Out-of-Pocket

$3,500

Family

Deductible

$2,800

Max Out-of-Pocket

$7,000




Deductibles

In-network

Individual

$1,400

Family

$2,800

Out-of-Pocket Limits

In-network

Individual

$3,500

Family

$7,000


What is covered?

COVERAGE TYPE
In-Network You Pay

Medical and Hospital Benefits

Medical Coverage


Preventive Services

$0

Primary Care Provider (PCP) Office Visit when affiliated with a Patient Centered Medical Home (PCMH)

$15 after deductible

PCP not affiliated with a PCMH

$35 after deductible

Telemedicine

$0 after deductible

Retail Clinic

$40 after deductible

Specialist Visit

$40 after deductible

Urgent Care Center

$75 after deductible

Emergency Room

$150 after deductible

Diagnostic Laboratory Tests

$0 after deductible

X-rays

$0 after deductible

High End Radiology (i.e., MRI, PET, and CAT scans etc.)

$150 after deductible

Inpatient Hospital

$200 per admission after deductible

Pediatric Vision Eyeware (Dependents under 19)


Collection prescription glasses, lenses, and collection contact lenses

$0 after deductible

Pediatric Dental (Dependent under 19)


Oral exams, cleanings, x-rays, fluoride treatments, sealants and space maintainers

$0 after deductible

All other covered dental services

50% after deductible

Prescription Drug Benefits

Tier 1 (Preferred Generic)

$10 after deductible

Tier 2 (Non-preferred Generic)

$25 after deductible

Tier 3 (Preferred Brand)

$50 after deductible

Tier 4 (Non-Preferred Brand)

$75 after deductible

Tier 5 (Specialty)

$125 after deductible

I would like coverage for .
My household income is per year and there is/are person/people in my household.

No thanks, I prefer not to answer these tax questions.

Based on your responses, it appears you may qualify for a tax subsidy.

Assistance is available if you need help with the calculator.

Based on your responses, it appears you don’t qualify for a tax subsidy.