Healthy Blue's preventive covered services are designed as a strategy to maintain good health and prevent illness. A combination of several fully covered medical services and fully covered preventive radiology and lab services serve as the cornerstone of an affordable health care insurance plan. Early detection through preventive screenings is a key part of Healthy Blue's approach to health care.
Learn how the Blue Choice network enhances your Healthy Blue coverage
Office Visits & Services
Up to three office visits are paid at 100% during the benefit period, then subject to deductible and coinsurance. The benefit period is the 12-month period that begins on the first day of a given month. There is no family limit. Office visits include both wellness checkups and treatment of illness.
Immunizations
Immunizations up to age 72 months are covered 100% of the maximum allowance.
Preventive Radiology & Lab Services
From routine Ob/Gyn exams to heart disease prevention, screenings for a multitude of diseases and disorders are covered 100% of maximum allowance.
Flu Shots
One shot per member, per year, is covered 100% of maximum allowance.
Non-preventive Outpatient Radiology & Lab Services
Pays 100% of the allowable charge to a maximum of $300 per person each benefit period, then subject to deductible and coinsurance. There is no family limit. This benefit includes radiology and services resulting from an accidental injury.
Accidental Injury Services
Pay 100% up to $500 per person each benefit period, then subject to deductible and coinsurance. This benefit does not include radiology, lab services or ambulance services.
Preventive Care
Paid at 100 percent of the allowable charge. Includes routine screenings, immunizations, checkups and counseling received to prevent illness or disease.
Home Health Care
Healthy Blue pays home health care at 100% of allowable charges.
Hospice
Hospice is paid at 100% with a $5,000 lifetime maximum.
Dependents
Your dependents are covered to age 26.
Outpatient Prescription Drugs
Generic drugs have a $5 copay and then are paid at 100%. Brand (formulary/non-formulary) drugs have a $200 deductible for each covered person and $600 deductible for three-or-more persons. After meeting the deductible, the member pays 50% of the allowed charges for the remainder of the benefit period.
Lifetime Maximum
Each covered person has an unlimited lifetime maximum benefit.
Deductible and Other Covered Services
Healthy Blue includes a $2,000 deductible for each covered person and $6,000 maximum for three or more persons. After meeting the deductible, you pay 50% of allowed amounts to a maximum of $5,000; $15,000 maximum for three or more persons. After the annual out-of-pocket is met, Healthy Blue pays 100% of the allowed charges for the remainder of the benefit period.
Covered Services include:
Optional Benefits:
Exclusions
See the Exclusions page for details.
Additional Program Information
More Information
Contact us to learn more about the features of Healthy Blue.