Florida health plan · 2026

BlueSelect Gold 1535V ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Adult Vision / Rewards) · 16842FL0310001

Blue Cross Blue Shield of Florida offers this marketplace health insurance plan (Plan ID 16842FL0310001) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.

Metal level: Gold Plan type: EPO CSR: Zero Cost Sharing Plan Variation Issuer: Blue Cross Blue Shield of Florida
Telehealth Data pending HSA eligible No Dental Not listed Vision Adult/Child
Pay / Manage Plan View issuer site

CMS AV Calculator output: 100.00% (0.00% member share on average). Learn about AV methodology.

2026 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 02 Dec 2025 06:13 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.

Monthly premium

$472 – $3541

Before subsidies

Estimate after subsidies

Deductible

N/A

N/A

See deductible details

Max out-of-pocket

$0

$0 per group

Review MOOP rules

Office visits

Primary care $0.00, 0.00%
Specialist $0.00, 0.00%
HSA Not eligible

Drug tiers

Generic $0.00, 0.00%
Preferred brand $0.00, 0.00%

View formulary tiers

$902 / mo before subsidies

≈ $10820 per year before tax credits.

Start with this unsubsidized premium, then apply marketplace tax credits to see your final monthly payment.

  • Ideal for shoppers comparing Bronze vs. Silver budgets.
  • Update your Marketplace application to apply premium tax credits.

$3001 / mo before subsidies

≈ $36010 per year before tax credits.

Pre-subsidy rate for a couple with one dependent. Switch to Silver CSR plans if you qualify to reduce these numbers.

  • Compares well against PPO vs HMO networks when planning for childcare and telehealth needs.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$3195 / mo before subsidies

≈ $38336 per year before tax credits.

Pairs with cost-sharing reductions (CSR) when you select a Silver tier and qualify based on income.

  • Use this estimate before adding childcare, dental, or vision extras.
  • CSR Silver variants can lower deductibles dramatically for eligible incomes.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$2379 / mo before subsidies

≈ $28544 per year before tax credits.

Shows the combined pre-subsidy rate for two adults. Add dependents or subsidies in your application to refine it.

  • Great for households deciding between PPO and HMO networks.
  • Telehealth and HSA perks (when offered) apply to both members.
Issuer profile See benefits

Preventive Care/Screening/Immunization

$0.00, 0.00%

Emergency Room Services

$0.00, 0.00%

Durable Medical Equipment

$0.00, 0.00%

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Enrollment guidance

Stay on top of 2026 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2026 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Florida). Submit changes before the deadline to avoid a coverage gap.

  • Enroll by Dec 15 for Jan 1 starts.
  • Finalize plan switches before the window closes.

Special Enrollment Periods

You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).

  • Report the event within 60 days.
  • Keep documentation handy for Healthcare.gov or your state exchange.

CSR & subsidy reminders

Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.

  • Enter accurate income to maximize Advanced Premium Tax Credits.
  • Zero Cost Sharing Plan Variation plans like this one keep deductibles and copays lower if you qualify.

Thinking about switching?

Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.

  • Match provider networks so ongoing care isn’t disrupted.
  • Confirm prescriptions stay on-formulary or budget for tier changes.

Top covered benefits

How this plan handles key care scenarios

Preventive Care/Screening/Immunization

$0.00, 0.00%

Emergency Room Services

$0.00, 0.00%

Durable Medical Equipment

$0.00, 0.00%

Premium snapshot

Plan identifiers & filings

Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.

Plan ID 16842FL0310001
Coverage year 2026
State Florida
Issuer Blue Cross Blue Shield of Florida
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 16842FL0310001-02
Available variants

Standard Off Exchange Plan · 16842FL0310001-00

Standard On Exchange Plan · 16842FL0310001-01

Open to Indians below 300% FPL · 16842FL0310001-02

Open to Indians above 300% FPL · 16842FL0310001-03
Last plan update Wed, 15 Oct 2025 00:00 GMT
Last HealthPorta import Tue, 02 Dec 2025 06:13 GMT

Network stats

Provider access snapshot

Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).

All providers in Florida 4187
PCPs in Florida 917
Telehealth support Data pending
Nationwide providers 4372
4,187 doctors statewide 917 PCPs 12 OB/GYN

Provider network(s)

Providers Florida All US states
All 4187 4372
PCP 917 954
Allergy 6 7
OB/GYN 12 12
Dentists 19 19

Drug coverage overview

5,204 drugs tracked

Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.

Tier Covered drugs
PREFERRED-GENERIC 1,739
NON-PREFERRED-BRAND 1,267
SPECIALTY-DRUGS 1,242
GENERIC 559
ZERO-COST-SHARE-PREVENTIVE-DRUGS 345
BRAND 51
UNKNOWN 1
Prior authorization Drugs
Required 1,361
Not Required 3,843
Step therapy Drugs
Required 124
Not Required 5,080
Quantity limits Drugs
Has Limit 2,006
No Limit 3,198

Customer highlights

What stands out for members

  • Issuer: Blue Cross Blue Shield of Florida · Plan ID 16842FL0310001 · 2026 filing.
  • Disease management programs available: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Pain Management, Pregnancy.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 16842FL0310001-02 (Open to Indians below 300% FPL) currently displayed.
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Benefits

Covered services & limitations

Everyday care

Office visits, preventive care, labs, imaging, and home health.

Chiropractic Care

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Limit: 35.0 Procedure(s) per Benefit Period

Combined limit for all outpatient therapy plus chiropractic.

Diabetes Care Management

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Diabetes Education

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Home Health Care Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network 100.00%

Limit: 60.0 Visit(s) per Benefit Period

Laboratory Outpatient and Professional Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network 100.00%

Other Practitioner Office Visit (Nurse, Physician Assistant)

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Preventive Care/Screening/Immunization

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Primary Care Visit to Treat an Injury or Illness

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

No charge for unlimited visits rendered by Value Choice Providers. Check your Online Provider Directory for providers in your area. Virtual visits are covered at No Cost when received from our in-network preferred providers or vendor. Please refer to the plan policy documents (e.g., Summary of Benefits and Coverage) for detailed information.

Rehabilitative Occupational and Rehabilitative Physical Therapy

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Limit: 35.0 Visit(s) per Benefit Period

Combined limit for all outpatient therapy plus chiropractic.

Rehabilitative Speech Therapy

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Limit: 35.0 Visit(s) per Benefit Period

Combined limit for all outpatient therapy plus chiropractic.

Specialist Visit

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Urgent Care Centers or Facilities

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Reduced cost available at Value Choice Providers. Check your Online Provider Directory for providers in your area.

X-rays and Diagnostic Imaging

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Bone Marrow Transplant

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

In-Network Only: The cost share is applied for a max of 3 days per admission.

Chemotherapy

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Delivery and All Inpatient Services for Maternity Care

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

In-Network Only: The cost share is applied for a max of 3 days per admission.

Dialysis

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Durable Medical Equipment

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network 100.00%

Emergency Room Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Emergency Transportation/Ambulance

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Hospice Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Inpatient Hospital Services (e.g., Hospital Stay)

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

In-Network Only: The cost share is applied for a max of 3 days per admission.

Inpatient Physician and Surgical Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Mental/Behavioral Health Inpatient Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Mental/Behavioral Health Outpatient Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

The cost sharing that displays applies to outpatient office visits only. Other outpatient services (e.g., outpatient hospital) may be subject to additional cost sharing. Virtual visits are covered at No Cost when received from our in-network preferred providers or vendor. Please refer to the plan policy documents (e.g., Summary of Benefits and Coverage) for detailed information.

Outpatient Facility Fee (e.g., Ambulatory Surgery Center)

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Outpatient Rehabilitation Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Limit: 35.0 Visit(s) per Benefit Period

Combined limit for all outpatient therapy plus chiropractic.

Outpatient Surgery Physician/Surgical Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Radiation

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Skilled Nursing Facility

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Limit: 60.0 Days per Benefit Period

Substance Abuse Disorder Inpatient Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Substance Abuse Disorder Outpatient Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

The cost sharing that displays applies to outpatient office visits only. Other outpatient services (e.g., outpatient hospital) may be subject to additional cost sharing. Virtual visits are covered at No Cost when received from our in-network preferred providers or vendor. Please refer to the plan policy documents (e.g., Summary of Benefits and Coverage) for detailed information.

Transplant

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

In-Network Only: The cost share is applied for a max of 3 days per admission.

Pregnancy & family

Maternity, newborn, pediatric dental and vision extras.

Basic Dental Care - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Hearing Aids

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Major Dental Care - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Prenatal and Postnatal Care

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Routine Eye Exam for Children

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network 100.00%

Limit: 1.0 Visit(s) per Year

Well Baby Visits and Care

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network 100.00%

In-Network Only: $0 preventive and $4 generics for certain drugs, plus Mail Order for these drugs is $0.

Non-Preferred Brand Drugs

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network 100.00%

Off Label Prescription Drugs

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network 100.00%

Preferred Brand Drugs

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network 100.00%

In-Network Only: Certain drugs are available for a lower cost.

Specialty Drugs

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network 100.00%

Wellness & extras

Vision, dental, therapies, prosthetics, weight management.

Accidental Dental

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Basic Dental Care - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Dental Anesthesia

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Dental Check-Up for Children

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Infusion Therapy

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Major Dental Care - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Nutritional Counseling

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Nutrition/Formulas

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Orthodontia - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Orthodontia - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Prosthetic Devices

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network 100.00%

Routine Dental Services (Adult)

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Weight Loss Programs

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Additional benefits

Other plan-specific services and limitations.

Abortion for Which Public Funding is Prohibited

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Acupuncture

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Allergy Testing

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Bariatric Surgery

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Congenital Anomaly, including Cleft Lip/Palate

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Cosmetic Surgery

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Eye Glasses for Children

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network 100.00%

Limit: 1.0 Item(s) per Year

Habilitation Services

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Limit: 35.0 Visit(s) per Benefit Period

Supplementing with the federal definition of habilitative services: Health care services that help a person keep, learn, or improve skills and functioning for daily living. Examples include therapy for a child who is not walking or talking at the expected age. These services may include physical and occupational therapy, speech-language pathology and other services for people with disabilities in a variety of inpatient and/or outpatient settings.

Imaging (CT/PET Scans, MRIs)

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Infertility Treatment

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Long-Term/Custodial Nursing Home Care

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Osteoporosis

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Private-Duty Nursing

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Reconstructive Surgery

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Only for Breast reconstruction following a Mastectomy.

Routine Eye Exam (Adult)

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network 100.00%

Limit: 1.0 Exam(s) per Year

See Policy for details

Routine Foot Care

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Only covered when medically necessary.

Treatment for Temporomandibular Joint Disorders

$0.00, 0.00%
Tier 1 in-network $0.00, 0.00%
Tier 2 in-network $0.00, 0.00%
Out-of-network $0.00, 0.00%

Variant attributes

BlueSelect Gold 1535V ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Adult Vision / Rewards) · Variant 16842FL0310001-02

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2026

CSR Variation Type

Zero Cost Sharing Plan Variation

HIOS Product ID

16842FL031

Metal Level

Gold

Plan ID (Standard Component ID with Variant)

16842FL0310001-02

Plan Marketing Name

BlueSelect Gold 1535V ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Adult Vision / Rewards)

Plan Variant Marketing Name

BlueSelect Gold 1535UV

Issuer & service area

Issuer-provided metadata for this variant.

Issuer ID

16842

Issuer Marketplace Marketing Name

Florida Blue (BlueCross BlueShield FL)

Market Coverage

Individual

Multiple In Network Tiers

Yes

National Network

Yes

Network ID

FLN002

Out of Country Coverage

Yes

Out of Country Coverage Description

Covered services as outlined in the member contract.

Out of Service Area Coverage

Yes

Out of Service Area Coverage Description

Covered services as outlined in the member contract.

Service Area ID

FLS002

State Code

FL

URL for Summary of Benefits & Coverage

Open link

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

AV Calculator Output Number

1

Begin Primary Care Deductible Coinsurance After Number Of Copays

0

Drug EHB Deductible, In Network (Tier 1), Default Coinsurance

0.00%

Drug EHB Deductible, In Network (Tier 2), Default Coinsurance

0.00%

Inpatient Copayment Maximum Days

0

Medical Drug Deductibles Integrated

No

Medical Drug Maximum Out of Pocket Integrated

Yes

Medical EHB Deductible, In Network (Tier 1), Default Coinsurance

0.00%

Medical EHB Deductible, In Network (Tier 2), Default Coinsurance

0.00%

SBC Scenario, Having a Baby, Coinsurance

$0

SBC Scenario, Having a Baby, Copayment

$0

SBC Scenario, Having a Baby, Deductible

$0

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$0

SBC Scenario, Having Diabetes, Deductible

$0

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$0

SBC Scenario, Treatment of a Simple Fracture, Copayment

$0

SBC Scenario, Treatment of a Simple Fracture, Deductible

$0

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group

$0 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person

$0 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual

$0

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group

$0 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person

$0 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual

$0

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Family Per Group

$0 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Family Per Person

$0 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 2), Individual

$0

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group

$0 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person

$0 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual

$0

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

FLF021

Formulary URL

Open link

Plan Brochure

Open link

SBC Scenario, Having a Baby, Limit

$60

SBC Scenario, Having Diabetes, Limit

$0

SBC Scenario, Treatment of a Simple Fracture, Limit

$0

URL for Enrollment Payment

Open link

Additional attributes

Issuer-provided metadata for this variant.

Begin Primary Care Cost-Sharing After Number Of Visits

0

Child-Only Offering

Allows Adult and Child-Only

Composite Rating Offered

No

Drug EHB Deductible, Combined In/Out of Network, Family Per Group

$0 per group

Drug EHB Deductible, Combined In/Out of Network, Family Per Person

$0 per person

Drug EHB Deductible, Combined In/Out of Network, Individual

$0

Drug EHB Deductible, In Network (Tier 1), Family Per Group

$0 per group

Drug EHB Deductible, In Network (Tier 1), Family Per Person

$0 per person

Drug EHB Deductible, In Network (Tier 1), Individual

$0

Drug EHB Deductible, In Network (Tier 2), Family Per Group

$0 per group

Drug EHB Deductible, In Network (Tier 2), Family Per Person

$0 per person

Drug EHB Deductible, In Network (Tier 2), Individual

$0

Drug EHB Deductible, Out of Network, Family Per Group

$0 per group

Drug EHB Deductible, Out of Network, Family Per Person

$0 per person

Drug EHB Deductible, Out of Network, Individual

$0

Dental Only Plan

No

Design Type

Not Applicable

Disease Management Programs Offered

Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Pain Management, Pregnancy

EHB Percent of Total Premium

0.9963

First Tier Utilization

0%

Import Date

10/15/2025

Limited Cost Sharing Plan Variation - Estimated Advanced Payment

$0.00

HSA Eligible

No

New/Existing Plan

Existing

Notice Required for Pregnancy

No

Is a Referral Required for Specialist?

No

Medical EHB Deductible, Combined In/Out of Network, Family Per Group

$0 per group

Medical EHB Deductible, Combined In/Out of Network, Family Per Person

$0 per person

Medical EHB Deductible, Combined In/Out of Network, Individual

$0

Medical EHB Deductible, In Network (Tier 1), Family Per Group

$0 per group

Medical EHB Deductible, In Network (Tier 1), Family Per Person

$0 per person

Medical EHB Deductible, In Network (Tier 1), Individual

$0

Medical EHB Deductible, In Network (Tier 2), Family Per Group

$0 per group

Medical EHB Deductible, In Network (Tier 2), Family Per Person

$0 per person

Medical EHB Deductible, In Network (Tier 2), Individual

$0

Medical EHB Deductible, Out of Network, Family Per Group

$0 per group

Medical EHB Deductible, Out of Network, Family Per Person

$0 per person

Medical EHB Deductible, Out of Network, Individual

$0

Plan Effective Date

1/1/2026

Plan Expiration Date

12/31/2026

Plan Type

EPO

QHP/Non QHP

Both

Second Tier Utilization

100%

Source Name

HIOS

Plan ID

16842FL0310001

Unique Plan Design

No

Wellness Program Offered

No

Copay & coinsurance

Pharmacy cost sharing by tier

Drug tier Pharmacy type Copay amount Copay option Coinsurance rate Coinsurance option Mail order

Questions & answers

Frequently asked questions

How do I choose the right ACA plan in Florida?

BlueSelect Gold 1535V ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Adult Vision / Rewards) (16842FL0310001) is a Gold EPO from Blue Cross Blue Shield of Florida in Florida for the 2026 coverage year.

Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.

Does BlueSelect Gold 1535V ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Adult Vision / Rewards) support telehealth or virtual urgent care?

The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.

Is BlueSelect Gold 1535V ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Adult Vision / Rewards) HSA-eligible and does it include dental or vision coverage?

It is not marked as HSA-eligible, so confirm with the issuer before relying on tax-advantaged savings.

Dental coverage is not listed for this plan.

Vision add-ons: Adult, Child.

Does BlueSelect Gold 1535V ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Adult Vision / Rewards) support mail-order prescriptions?

Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.

Which disease management programs come with BlueSelect Gold 1535V ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Adult Vision / Rewards)?

The issuer lists disease management resources for: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Pain Management, Pregnancy.

Is there out-of-country coverage for BlueSelect Gold 1535V ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Adult Vision / Rewards)?

Yes, limited out-of-country coverage is available. Review the Summary of Benefits for reimbursement steps. Details: Covered services as outlined in the member contract.

Does BlueSelect Gold 1535V ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Adult Vision / Rewards) cover care outside the service area?

Yes, you have limited out-of-area coverage. See the plan documents for referral and prior authorization rules. Details: Covered services as outlined in the member contract.

Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
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