myBlue Silver 26M03-02E ($0 Primary Care Visits with Select Providers / $5 Labs / Adult Dental & Vision / Rewards)

Florida Blue HMO (a BlueCross BlueShield FL company) · 2026 plan year

Silver
Ind. deductible
$9,500
Family deductible
$19,000
Ind. OOP max
$10,025
Family OOP max
$20,050

Compare with other Silver plans in FL

Side by side: deductibles, out-of-pocket limits and copays.

More Florida Blue HMO (a BlueCross BlueShield FL company) plans in FL

Monthly premiums by age

Rating Area 28 — the lowest-priced of the 8 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$393$393
21$514$555
30$583$656
40$657$772
50$918$1,102
60$1,395$1,674
64 and over$1,542$1,851

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or IllnessNo charge

Specialist

BenefitIn-network
Specialist Visit$130.00 Copay after deductible

Hospital

BenefitIn-network
Emergency Room Services50.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)50.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical ServicesNo charge
Urgent Care Centers or Facilities$130.00 Copay after deductible

Pharmacy

BenefitIn-network
Generic Drugs$40.00 Copay after deductible
Non-Preferred Brand Drugs50.00% Coinsurance after deductible
Off Label Prescription Drugs50.00% Coinsurance after deductible
Preferred Brand Drugs$70.00 Copay after deductible
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient ServicesNo charge

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental$130.00 Copay after deductible
AcupunctureNot covered
Allergy Testing$130.00 Copay after deductible
Bariatric SurgeryNot covered
Basic Dental Care - Adult50.00% Coinsurance after deductible
Basic Dental Care - ChildNot covered
Bone Marrow Testing50.00% Coinsurance after deductible
Chemotherapy50.00% Coinsurance after deductible
Chiropractic Care$130.00 Copay after deductible
Congenital Anomaly, including Cleft Lip/Palate50.00% Coinsurance after deductible
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care50.00% Coinsurance after deductible
Dental Anesthesia$130.00 Copay after deductible
Dental Check-Up for ChildrenNot covered
Diabetes Care Management$130.00 Copay after deductible
Diabetes EducationNo charge
Dialysis50.00% Coinsurance after deductible
Durable Medical EquipmentNo charge
Emergency Transportation/Ambulance50.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Habilitation Services$130.00 Copay after deductible
Hearing AidsNot covered
Home Health Care ServicesNo charge
Hospice ServicesNo charge
Imaging (CT/PET Scans, MRIs)50.00% Coinsurance after deductible
Infertility TreatmentNot covered
Infusion Therapy50.00% Coinsurance after deductible
Inpatient Physician and Surgical ServicesNo charge
Laboratory Outpatient and Professional Services$5.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - Adult50.00% Coinsurance after deductible
Major Dental Care - ChildNot covered
Nutrition/Formulas50.00% Coinsurance after deductible
Nutritional Counseling$130.00 Copay after deductible
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Osteoporosis$130.00 Copay after deductible
Other Practitioner Office Visit (Nurse, Physician Assistant)$130.00 Copay after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)50.00% Coinsurance after deductible
Outpatient Rehabilitation Services$130.00 Copay after deductible
Prenatal and Postnatal Care$130.00 Copay after deductible
Private-Duty NursingNot covered
Prosthetic DevicesNo charge
Radiation50.00% Coinsurance after deductible
Reconstructive Surgery50.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$130.00 Copay after deductible
Rehabilitative Speech Therapy$130.00 Copay after deductible
Routine Dental Services (Adult)No charge
Routine Eye Exam (Adult)No charge
Routine Eye Exam for ChildrenNo charge
Routine Foot Care$130.00 Copay after deductible
Skilled Nursing Facility$1000.00 Copay per Stay
Substance Abuse Disorder Inpatient Services50.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient ServicesNo charge
Transplant50.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders$130.00 Copay after deductible
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic ImagingNo charge

Plan rules

Service area

This plan covers 8 geographic areas.

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