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

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

2018 VantageBlue Direct 3250/6500

This plan gives you the highest levels of coverage and flexibility to choose what doctors you see. You will have access to our national network of doctors (across all 50 states), labs, and hospitals, with no referral required.

  • Provides coverage for most office visits before deductible
  • Full coverage for many preventive services, like an annual physical
  • Includes dental and vision coverage for dependents under the age of 19
  • $2 copayments for certain prescription drugs used to treat diabetes, asthma and chronic obstructive pulmonary disorders (COPD)
  • $0 copayments for an annual foot and eye exam for members with diabetes
  • $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 thousands of CVS branded health items
  • View benefit information on Your Blue Touch RI mobile app







Out-of-Pocket Limits






What is covered?

In-Network You Pay

Medical and Hospital Benefits

Medical Coverage

Preventive Services


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

$30 (First sick visit is free)

PCP not affiliated with a PCMH

$40 (First sick visit is free)



Retail Clinic


Specialist Visit


Annual foot and eye exam for members with diabetes


Urgent Care Center


Emergency Room


Diagnostic Laboratory Tests

20% after deductible


20% after deductible

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

20% after deductible

Inpatient Hospital

20% after deductible

Pediatric Vision Eyeware (Dependents under 19)

Collection prescription glasses, lenses, and collection contact lenses


Pediatric Dental (Dependent under 19)

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


All other covered dental services


Prescription Drug Benefits

Tier 1 (Preferred Generic)


Tier 2 (Non-preferred Generic)


Tier 3 (Preferred Brand)


Tier 4 (Non-Preferred Brand)


Tier 5 (Specialty)


Certain maintenance prescriptions for diabetes, asthma, and chronic obstructive pulmonary disease (COPD)