Florida health plan · 2026

BlueSelect Silver 1443V ($10 Labs / Adult Vision / Rewards) · 16842FL0310004

Blue Cross Blue Shield of Florida offers this marketplace health insurance plan (Plan ID 16842FL0310004) 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: Silver Plan type: EPO CSR: 87% AV Level Silver Plan Issuer: Blue Cross Blue Shield of Florida
Telehealth Data pending HSA eligible No Dental Not listed Vision Adult/Child

CMS AV Calculator output: 87.84% (12.16% 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

$400 – $2999

Before subsidies

Estimate after subsidies

Deductible

$0

$0 per group

See deductible details

Max out-of-pocket

$3,350

$6700 per group

Review MOOP rules

Office visits

Primary care No Charge
Specialist $70.00
HSA Not eligible

Drug tiers

Generic $25.00
Preferred brand $47.00

View formulary tiers

$760 / mo before subsidies

≈ $9125 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.

$2012 / mo before subsidies

≈ $24145 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.
  • This Silver tier qualifies for CSR if household income is ≤250% FPL.

$2713 / mo before subsidies

≈ $32551 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.
  • This Silver tier qualifies for CSR if household income is ≤250% FPL.

$1590 / mo before subsidies

≈ $19075 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

No Charge

Emergency Room Services

$675.00

Durable Medical Equipment

No Charge

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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.
  • 87% AV Level Silver Plan 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

No Charge

Emergency Room Services

$675.00

Durable Medical Equipment

No Charge

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.

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
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 1,736
NON-PREFERRED-BRAND 1,273
SPECIALTY-DRUGS 1,242
GENERIC 559
ZERO-COST-SHARE-PREVENTIVE-DRUGS 345
BRAND 48
UNKNOWN 1
Prior authorization Drugs
Required 1,364
Not Required 3,840
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 16842FL0310004 · 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 16842FL0310004-05 (87% AV Silver Plan) currently displayed.
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Benefits

Covered services & limitations

Everyday care

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

Chiropractic Care

$70.00

Diabetes Care Management

$70.00

Diabetes Education

No Charge

Home Health Care Services

No Charge

Laboratory Outpatient and Professional Services

$10.00

Other Practitioner Office Visit (Nurse, Physician Assistant)

$70.00

Preventive Care/Screening/Immunization

No Charge

Primary Care Visit to Treat an Injury or Illness

No Charge

Rehabilitative Occupational and Rehabilitative Physical Therapy

$70.00

Rehabilitative Speech Therapy

$70.00

Specialist Visit

$70.00

Urgent Care Centers or Facilities

$70.00

X-rays and Diagnostic Imaging

$100.00

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Bone Marrow Transplant

40.00%

Chemotherapy

40.00%

Delivery and All Inpatient Services for Maternity Care

40.00%

Dialysis

40.00%

Durable Medical Equipment

No Charge

Emergency Room Services

$675.00

Emergency Transportation/Ambulance

40.00%

Hospice Services

No Charge

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

40.00%

Inpatient Physician and Surgical Services

No Charge

Mental/Behavioral Health Inpatient Services

No Charge

Mental/Behavioral Health Outpatient Services

$5.00

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

40.00%

Outpatient Rehabilitation Services

$70.00

Outpatient Surgery Physician/Surgical Services

No Charge

Radiation

40.00%

Skilled Nursing Facility

$350.00 Copay per Stay

Substance Abuse Disorder Inpatient Services

No Charge

Substance Abuse Disorder Outpatient Services

$5.00

Transplant

40.00%

Pregnancy & family

Maternity, newborn, pediatric dental and vision extras.

Basic Dental Care - Child

Coverage details pending

Hearing Aids

Coverage details pending

Major Dental Care - Child

Coverage details pending

Prenatal and Postnatal Care

$70.00

Routine Eye Exam for Children

No Charge

Well Baby Visits and Care

No Charge

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

$25.00

Non-Preferred Brand Drugs

40.00%

Off Label Prescription Drugs

40.00%

Preferred Brand Drugs

$47.00

Specialty Drugs

50.00%

Wellness & extras

Vision, dental, therapies, prosthetics, weight management.

Accidental Dental

$70.00

Basic Dental Care - Adult

Coverage details pending

Dental Anesthesia

$70.00

Dental Check-Up for Children

Coverage details pending

Infusion Therapy

40.00%

Major Dental Care - Adult

Coverage details pending

Nutritional Counseling

$70.00

Nutrition/Formulas

40.00%

Orthodontia - Adult

Coverage details pending

Orthodontia - Child

Coverage details pending

Prosthetic Devices

No Charge

Routine Dental Services (Adult)

Coverage details pending

Weight Loss Programs

Coverage details pending

Additional benefits

Other plan-specific services and limitations.

Abortion for Which Public Funding is Prohibited

Coverage details pending

Acupuncture

Coverage details pending

Allergy Testing

$70.00

Bariatric Surgery

Coverage details pending

Congenital Anomaly, including Cleft Lip/Palate

40.00%

Cosmetic Surgery

Coverage details pending

Eye Glasses for Children

No Charge

Habilitation Services

$70.00

Imaging (CT/PET Scans, MRIs)

40.00%

Infertility Treatment

Coverage details pending

Long-Term/Custodial Nursing Home Care

Coverage details pending

Osteoporosis

$70.00

Private-Duty Nursing

Coverage details pending

Reconstructive Surgery

40.00%

Routine Eye Exam (Adult)

No Charge

Routine Foot Care

$70.00

Treatment for Temporomandibular Joint Disorders

$70.00

Variant attributes

BlueSelect Silver 1443V ($10 Labs / Adult Vision / Rewards) · Variant 16842FL0310004-05

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2026

CSR Variation Type

87% AV Level Silver Plan

HIOS Product ID

16842FL031

Metal Level

Silver

Plan ID (Standard Component ID with Variant)

16842FL0310004-05

Plan Marketing Name

BlueSelect Silver 1443V ($10 Labs / Adult Vision / Rewards)

Plan Variant Marketing Name

BlueSelect Silver 1443BV ($0 Deductible / $5 PCP Visits / $70 Specialist Visits / $10 Labs / Adult Vision / Rewards)

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

0.878449505

Begin Primary Care Deductible Coinsurance After Number Of Copays

0

Inpatient Copayment Maximum Days

0

Medical Drug Deductibles Integrated

Yes

Medical Drug Maximum Out of Pocket Integrated

Yes

SBC Scenario, Having a Baby, Coinsurance

$2,800

SBC Scenario, Having a Baby, Copayment

$100

SBC Scenario, Having a Baby, Deductible

$0

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$1,600

SBC Scenario, Having Diabetes, Deductible

$0

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$400

SBC Scenario, Treatment of a Simple Fracture, Copayment

$600

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

per group not applicable

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

per person not applicable

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

Not Applicable

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

40.00%

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

40.00%

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

$6700 per group

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

$3350 per person

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

$3,350

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

$6700 per group

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

$3350 per person

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

$3,350

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

$32400 per group

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

$16200 per person

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

$16,200

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

FLF014

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

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

0.9957

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

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

16842FL0310004

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

per group not applicable

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

per person not applicable

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

Not Applicable

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

$0 per group

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

$0 per person

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual

$0

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

$0 per group

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

$0 per person

Combined Medical and Drug EHB Deductible, In Network (Tier 2), Individual

$0

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group

$16000 per group

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person

$8000 per person

Combined Medical and Drug EHB Deductible, Out of Network, Individual

$8,000

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 Silver 1443V ($10 Labs / Adult Vision / Rewards) (16842FL0310004) is a Silver 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 Silver 1443V ($10 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 Silver 1443V ($10 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 Silver 1443V ($10 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 Silver 1443V ($10 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 Silver 1443V ($10 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 Silver 1443V ($10 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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