BlueChoice Individual Coverage

BlueChoice Individual Coverage

This information applies to BlueChoice for Kids^SM or BlueChoice for Young Adults^SM products sold prior to Oct. 1, 2010. 

BlueChoice Individual Coverage^SM offers:

• Doctor's office visits
• Routine preventive office services
• Prescription drug card — copayment for generic drugs, preferred drugs and non-preferred drugs
• Vision care — free annual eye exam
• Dental care — $30 toward cleaning (one per benefit period) and $20 toward routine exam (one per benefit period)

Plan 1

• Benefits and Rates Guide for policies issued before March 23, 2010
• Benefits and Rates Guide for policies issued on or after March 23, 2010
• Contract
• Member Guide
• Outline of Coverage

Plan 2

• Benefits and Rates Guide for policies issued before March 23, 2010
• Benefits and Rates Guide for policies issued on or after March 23, 2010
• Contract
• Member Guide
• Outline of Coverage

Plan 3

• Benefits and Rates Guide for policies issued before March 23, 2010
• Benefits and Rates Guide for policies issued on or after March 23, 2010
• Contract
• Member Guide
• Outline of Coverage

Plan 4

• Benefits and Rates Guide for policies issued before March 23, 2010
• Benefits and Rates Guide for policies issued on or after March 23, 2010
• Contract
• Member Guide
• Outline of Coverage

Plan 5

• Benefits and Rates Guide for policies issued before March 23, 2010
• Benefits and Rates Guide for policies issued on or after March 23, 2010
• Contract
• Member Guide
• Outline of Coverage

Plan 6

• Benefits and Rates Guide for policies issued before March 23, 2010
• Benefits and Rates Guide for policies issued on or after March 23, 2010
• Contract
• Member Guide
• Outline of Coverage

Plan 7

• Benefits and Rates Guide for policies issued before March 23, 2010
• Benefits and Rates Guide for policies issued on or after March 23, 2010
• Contract
• Member Guide
• Outline of Coverage