Florida health plan · 2026

myBlue Silver 26M03-02 ($0 Primary Care Visits with Select Providers / $5 Labs / Rewards) · 30252FL0070061

Health Options, Inc. offers this marketplace health insurance plan (Plan ID 30252FL0070061) 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: HMO CSR: 87% AV Level Silver Plan Issuer: Health Options, Inc.
Telehealth Data pending HSA eligible No Dental Not listed Vision Child
Pay / Manage Plan View issuer site

CMS AV Calculator output: 87.57% (12.43% 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

$386 – $1731

Before subsidies

Estimate after subsidies

Deductible

$650

$1300 per group

See deductible details

Max out-of-pocket

$3,350

$6700 per group

Review MOOP rules

Office visits

Primary care No Charge
Specialist $40.00
HSA Not eligible

Drug tiers

Generic $40.00
Preferred brand $60.00 Copay after deductible

View formulary tiers

$605 / mo before subsidies

≈ $7256 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.

$1839 / mo before subsidies

≈ $22063 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.

$2215 / mo before subsidies

≈ $26580 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.

$1426 / mo before subsidies

≈ $17118 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

50.00% Coinsurance after deductible

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

50.00% Coinsurance after deductible

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.

Plan ID 30252FL0070061
Coverage year 2026
State Florida
Issuer Health Options, Inc.
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 30252FL0070061-05
Available variants

Standard Off Exchange Plan · 30252FL0070061-00

Standard On Exchange Plan · 30252FL0070061-01

Open to Indians below 300% FPL · 30252FL0070061-02

Open to Indians above 300% FPL · 30252FL0070061-03

73% AV Silver Plan · 30252FL0070061-04

87% AV Silver Plan · 30252FL0070061-05

94% AV Silver Plan · 30252FL0070061-06
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 70247
PCPs in Florida 14333
Telehealth support Data pending
Nationwide providers 126620
70,247 doctors statewide 14,333 PCPs 886 OB/GYN

Provider network(s)

Providers Florida All US states
All 70247 126620
PCP 14333 15528
Allergy 56 66
OB/GYN 886 989
Dentists 200 293

Drug coverage overview

4,184 drugs tracked

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

Tier Covered drugs
NON-PREFERRED-BRAND 2,300
PREFERRED-GENERIC 975
GENERIC 555
ZERO-COST-SHARE-PREVENTIVE-DRUGS 340
BRAND 13
UNKNOWN 1
Prior authorization Drugs
Required 1,066
Not Required 3,118
Step therapy Drugs
Required 74
Not Required 4,110
Quantity limits Drugs
Has Limit 1,569
No Limit 2,615

Customer highlights

What stands out for members

  • Issuer: Health Options, Inc. · Plan ID 30252FL0070061 · 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 30252FL0070061-05 (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

$40.00
Tier 1 in-network $40.00
Out-of-network 100.00%

Limit: 35.0 Procedure(s) per Benefit Period

Combined limit for all outpatient therapy plus chiropractic.

Diabetes Care Management

$40.00
Tier 1 in-network $40.00
Out-of-network 100.00%

Diabetes Education

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Home Health Care Services

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Limit: 60.0 Visit(s) per Benefit Period

Laboratory Outpatient and Professional Services

$5.00
Tier 1 in-network $5.00
Out-of-network 100.00%

Other Practitioner Office Visit (Nurse, Physician Assistant)

$40.00
Tier 1 in-network $40.00
Out-of-network 100.00%

Preventive Care/Screening/Immunization

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Primary Care Visit to Treat an Injury or Illness

No Charge
Tier 1 in-network No Charge
Tier 2 in-network $10.00
Out-of-network 100.00%

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

$20.00
Tier 1 in-network $20.00
Out-of-network 100.00%

Limit: 35.0 Visit(s) per Benefit Period

Combined limit for all outpatient therapy plus chiropractic.

Rehabilitative Speech Therapy

$20.00
Tier 1 in-network $20.00
Out-of-network 100.00%

Limit: 35.0 Visit(s) per Benefit Period

Combined limit for all outpatient therapy plus chiropractic.

Specialist Visit

$40.00
Tier 1 in-network $40.00
Out-of-network 100.00%

Urgent Care Centers or Facilities

$40.00
Tier 1 in-network $40.00
Tier 2 in-network $40.00
Out-of-network 100.00%

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

X-rays and Diagnostic Imaging

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Chemotherapy

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Delivery and All Inpatient Services for Maternity Care

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Dialysis

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Durable Medical Equipment

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Emergency Room Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Emergency Transportation/Ambulance

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 50.00% Coinsurance after deductible

Hospice Services

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

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

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Inpatient Physician and Surgical Services

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Mental/Behavioral Health Inpatient Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Mental/Behavioral Health Outpatient Services

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

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)

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Outpatient Rehabilitation Services

$20.00
Tier 1 in-network $20.00
Out-of-network 100.00%

Limit: 35.0 Visit(s) per Benefit Period

Combined limit for all outpatient therapy plus chiropractic.

Outpatient Surgery Physician/Surgical Services

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Radiation

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Skilled Nursing Facility

$700.00 Copay per Stay
Tier 1 in-network $700.00 Copay per Stay
Out-of-network 100.00%

Limit: 60.0 Days per Benefit Period

Substance Abuse Disorder Inpatient Services

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Substance Abuse Disorder Outpatient Services

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

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

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

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

$40.00
Tier 1 in-network $40.00
Out-of-network 100.00%

Routine Eye Exam for Children

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Limit: 1.0 Visit(s) per Year

Well Baby Visits and Care

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

$40.00
Tier 1 in-network $40.00
Out-of-network 100.00%

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

Non-Preferred Brand Drugs

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Off Label Prescription Drugs

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Preferred Brand Drugs

$60.00 Copay after deductible
Tier 1 in-network $60.00 Copay after deductible
Out-of-network 100.00%

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

Specialty Drugs

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Wellness & extras

Vision, dental, therapies, prosthetics, weight management.

Accidental Dental

$40.00
Tier 1 in-network $40.00
Out-of-network 100.00%

Basic Dental Care - Adult

Coverage details pending

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

Dental Anesthesia

$40.00
Tier 1 in-network $40.00
Out-of-network 100.00%

Dental Check-Up for Children

Coverage details pending

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

Infusion Therapy

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Major Dental Care - Adult

Coverage details pending

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

Nutritional Counseling

$40.00
Tier 1 in-network $40.00
Out-of-network 100.00%

Nutrition/Formulas

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

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

No Charge
Tier 1 in-network No Charge
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

$40.00
Tier 1 in-network $40.00
Out-of-network 100.00%

Bariatric Surgery

Coverage details pending

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

Bone Marrow Testing

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Congenital Anomaly, including Cleft Lip/Palate

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Cosmetic Surgery

Coverage details pending

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

Eye Glasses for Children

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Limit: 1.0 Item(s) per Year

Habilitation Services

$20.00
Tier 1 in-network $20.00
Out-of-network 100.00%

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)

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

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

$40.00
Tier 1 in-network $40.00
Out-of-network 100.00%

Private-Duty Nursing

Coverage details pending

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

Reconstructive Surgery

50.00% Coinsurance after deductible
Tier 1 in-network 50.00% Coinsurance after deductible
Out-of-network 100.00%

Only for Breast reconstruction following a Mastectomy.

Routine Eye Exam (Adult)

Coverage details pending

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

Routine Foot Care

$40.00
Tier 1 in-network $40.00
Out-of-network 100.00%

Only covered when medically necessary.

Treatment for Temporomandibular Joint Disorders

$40.00
Tier 1 in-network $40.00
Out-of-network 100.00%

Variant attributes

myBlue Silver 26M03-02 ($0 Primary Care Visits with Select Providers / $5 Labs / Rewards) · Variant 30252FL0070061-05

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2026

CSR Variation Type

87% AV Level Silver Plan

HIOS Product ID

30252FL007

Metal Level

Silver

Plan ID (Standard Component ID with Variant)

30252FL0070061-05

Plan Marketing Name

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

Plan Variant Marketing Name

myBlue Silver 26M03-02B ($0 Primary Care Visits with Select Providers / $40 Specialist Visits / $5 Labs / Rewards)

Issuer & service area

Issuer-provided metadata for this variant.

Issuer ID

30252

Issuer Marketplace Marketing Name

Florida Blue HMO (a BlueCross BlueShield FL company)

Market Coverage

Individual

Multiple In Network Tiers

Yes

National Network

No

Network ID

FLN002

Out of Country Coverage

Yes

Out of Country Coverage Description

Accident and emergency services.

Out of Service Area Coverage

Yes

Out of Service Area Coverage Description

Accident and emergency services.

Service Area ID

FLS005

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

0.8756661733941129

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

$2,600

SBC Scenario, Having a Baby, Copayment

$60

SBC Scenario, Having a Baby, Deductible

$650

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$1,600

SBC Scenario, Having Diabetes, Deductible

$650

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$300

SBC Scenario, Treatment of a Simple Fracture, Copayment

$200

SBC Scenario, Treatment of a Simple Fracture, Deductible

$650

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

50.00%

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

50.00%

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

per group not applicable

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

per person not applicable

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

Not Applicable

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

FLF019

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

1

First Tier Utilization

52%

Import Date

10/15/2025

Limited Cost Sharing Plan Variation - Estimated Advanced Payment

$0.00

HSA Eligible

No

New/Existing Plan

New

Notice Required for Pregnancy

No

Is a Referral Required for Specialist?

Yes

Plan Effective Date

1/1/2026

Plan Expiration Date

12/31/2026

Plan Type

HMO

QHP/Non QHP

Both

Second Tier Utilization

48%

Source Name

HIOS

Specialist Requiring a Referral

All Specialists require a referral with the exception of Chiropractors, Podiatrists, Dermatologists, Obstetric/Gynecologists, Behavioral Health Services, Physical Therapy, Occupational Therapy, and Speech Therapy.

Plan ID

30252FL0070061

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

$1300 per group

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

$650 per person

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

$650

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

$1300 per group

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

$650 per person

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

$650

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

per group not applicable

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

per person not applicable

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

Not Applicable

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?

myBlue Silver 26M03-02 ($0 Primary Care Visits with Select Providers / $5 Labs / Rewards) (30252FL0070061) is a Silver HMO from Health Options, Inc. 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 myBlue Silver 26M03-02 ($0 Primary Care Visits with Select Providers / $5 Labs / 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 myBlue Silver 26M03-02 ($0 Primary Care Visits with Select Providers / $5 Labs / 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: Child.

Does myBlue Silver 26M03-02 ($0 Primary Care Visits with Select Providers / $5 Labs / 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 myBlue Silver 26M03-02 ($0 Primary Care Visits with Select Providers / $5 Labs / 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 myBlue Silver 26M03-02 ($0 Primary Care Visits with Select Providers / $5 Labs / Rewards)?

Yes, limited out-of-country coverage is available. Review the Summary of Benefits for reimbursement steps. Details: Accident and emergency services.

Does myBlue Silver 26M03-02 ($0 Primary Care Visits with Select Providers / $5 Labs / 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: Accident and emergency services.

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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