Search results with tag "Bcbsfl"
Connected Care Silver Summary of Benefits and ... - bcbsfl.com
www.bcbsfl.commyBlue 2230C Coverage Period: 01/01/2022 - 12/31/2022 Connected Care Silver Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage for: Individual and/or Family | Plan Type: HMO 1 of 7 SBCID: 2332893 The Summary of Benefits and Coveragethe(SBC) document will help youGlossarychoose a health plan.
Drugs that are Not Covered - BCBSFL
www.bcbsfl.comDetrol LA capsules . dexamethasone 1.5 mg 6-day, 10-day, and 13-day blister packs . dexchlorpheniramine oral syrup (authorized generic for RyClora) Dexedrine Spansule . Dexilant capsules . DexPac 6-Day, 10-Day, and 13-Day blister packs . dextroamphetamine 15 mg, 20 mg and 30 mg tablets . diclofenac 1% topical gel . diclofenac 3% gel
Provider Administered Specialty Drugs - BCBSFL
www.bcbsfl.comProvider Administered Specialty Drugs* Current 1/1/22 . LDD: Limited Distribution Drug (Dispensing pharmacy can be found here: Limited Distribution Drugs ); PA: Prior Authorization; QL: Quantity Limit
myBlue Silver 1604 - BCBSFL
www.bcbsfl.commyBlue Silver 1604 Schedule of Benefits This Schedule of Benefits is part of your Contract, where more detailed information about your benefits can be found. Review this Schedule of Benefits carefully; it contains important information concerning your share of the expenses for Covered Services you receive. Amounts listed in this schedule are the
Open Medication Guide - BCBSFL
www.bcbsfl.comthe difference in cost between the generic medication and the brand name medication; and . the cost share applicable to brand name medication, as indicated on your Schedule of Benefits. Example: If your drug copay is $10 for generic and $40 for brand, and you choose a brand name drug when a generic is available, here is what you might pay.