Blue Saver Silver

Consider a Silver plan if you want lower monthly premiums and you use healthcare services every so often.

This plan requires you to designate a Primary Care Select Physician. You will only pay a $50 copay when visiting your designated physician.

Lower Premium

Lower Deductible

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 Calendar Year Deductible   $3,500 individual; $7,000 family
 Out-of-Pocket Maximum
  $8,150 individual; $16,300 family
 Primary Care Office Visit
  $50 copay. Each member must designate a Primary Care Select physician
 Specialist Office Visit   $75 copay. You must have a referral from your Primary Care Select physician
 Telephone and Online Video Consultations   You pay $45 per consultation 
 Outpatient Surgery
  25% member coinsurance, after meeting the calendar year deductible
 Emergency Room
  25% member coinsurance, after meeting the calendar year deductible
Pediatric Routine Dental Cleaning and Yearly Eye Exam     Routine Dental Cleaning: you pay $0; Yearly Eye Exam: you pay 25% member coinsurance, after meeting the calendar
  year deductible
 Prescription Drugs   Tier 1: $20 copay / Tier 2: $30 copay / Tiers 3-6: 25% member coinsurance, after meeting the calendar year deductible /
  Generic drugs are mandatory when available
 Notes   This plan uses the Source+Rx 1.0 Prescription Drug List and the ValueONE Network, which does not include all
   major retail chains. Check the pharmacy network
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