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How do I know where to go for care?

When you need care, choosing the right treatment option can help you avoid needless worry, higher out-of-pocket costs and hours of unnecessary waiting. Unless it’s an emergency, your primary care doctor should be your first choice when seeking care. And now, many members can get convenient care right from home.

If you get your health plan through your employer, check with your primary care doctor, behavioral health provider or specialist to see if they offer virtual care. And, be sure to check your cost share. With a virtual visit, you may be able to get care wherever you are for as low as a $0 copay. If your doctor isn’t available, you may be able to use Teladoc, the nation's largest virtual health care company. Check with human resources to verify your plan’s benefits.

If you buy your own plan for you and your family, virtual visits with designated primary care doctors and 24/7 care with Teladoc are available for a $0 out-of-pocket cost with most plans. Ask your doctor if they offer virtual visits.

To contact Teladoc, you can download the mobile app or call 800-TELADOC.

When you need care right away, but it's not life threatening, an urgent care center can cost less than the ER and have shorter wait times. Many times, an urgent care center can also provide any necessary labs or X-rays as part of your treatment. Always go to the nearest ER for life-threatening emergencies.

 

What do I need to know about in-network doctors?

Think of it this way: in-network is about getting health care from the broad range of providers who are part of your health plan. So, for in-network, that means a group of doctors, hospitals and other health care providers have agreed to give you discounted rates because you're a Florida Blue member. We negotiate for you, so, you’ll have less out-of-pocket costs when you get care. And they can’t send you a bill for more than what has been agreed to. This is called balance billing and you’re safe from it.

Out-of-network means you're getting care from providers who aren’t part of your health plan. You’ll probably have higher out-of-pocket costs when you see an out-of-network provider and they may balance bill you for the full amount for your care. Don't worry — if it's an emergency, you're always covered.

Staying in-network guarantees you cost savings because of the pre-negotiated, discounted rates. So, depending on your needs, it pays to stay in your health plan’s network.

 

Does Florida Blue offer virtual visits?

If you get your health plan through your employer, check with your primary care doctor, behavioral health provider or specialist to see if they offer virtual care. And, be sure to check your cost share. With a virtual visit, you may be able to get care wherever you are for as low as a $0 copay. If your doctor isn’t available, you may be able to use Teladoc, the nation’s largest virtual health care company. Check with human resources to verify your plan’s benefits.

If you buy your own plan for you and your family, virtual visits with designated primary care doctors and 24/7 care with Teladoc are available for a $0 out-of-pocket cost with most plans. Ask your doctor if they offer virtual visits.

To contact Teladoc, you can download the mobile app or call 800-TELADOC.

 

When should I choose my primary care doctor (PCP), urgent care or the ER?

If it's not an emergency, your primary care doctor should be your first choice when seeking care. Your PCP can treat common illnesses (cold, flu, sore throat, etc.) and minor injuries and conduct routine exams, vaccinations and screenings.

If you get your health plan through your employer, check with your primary care doctor, behavioral health provider or specialist to see if they offer virtual care. And, be sure to check your cost share. With a virtual visit, you may be able to get care wherever you are for as low as a $0 copay. If your doctor isn’t available, you may be able to use Teladoc, the nation’s largest virtual health care company. Check with human resources to verify your plan’s benefits.

If you buy your own plan for you and your family, virtual visits with designated primary care doctors and 24/7 care with Teladoc are available for a $0 out-of-pocket cost with most plans. Ask your doctor if they offer virtual visits.

To contact Teladoc, you can download the mobile app or call 800-TELADOC.

If you need care right away, use this guide to help decide where to go:

Urgent care centers are less expensive than ERs and often have shorter wait times. Many times, an urgent care center can also provide any necessary labs or X-rays as part of your treatment. Visit an urgent care center for conditions like:

  • Cold and flu-like symptoms
  • Migraines
  • Sinus infection
  • Urinary tract infection
  • Upper respiratory infections
  • Low back pain, strains, sprains and/or breaks
  • Mild burns

To find an in-network urgent care center (UCC) near you, click here.  For a broader list of UCCs, which includes out-of-network options, click here.

In a life-threatening emergency, always call 911 or go to the nearest ER. Examples of symptoms that require ER care include:

  • Severe chest pain (a possible heart attack)/li>
  • Signs of a possible stroke
  • Severe or sudden shortness of breath
  • Sudden or unexplained loss of consciousness

 

Going to an ER for nonemergent services can be very costly.  You could save on medical costs by choosing to go to an Urgent Care Center (UCC).

Example 1:

Going to an Urgent Care (UCC) for treatment of a Sprained Ankle

  • You Pay - $55*
  • Florida Blue Covers - $103*

Going to an ER for treatment of a Sprained Ankle

  • You Pay - $626*
  • Florida Blue Covers - $1,093*

Note: ER cost includes Facility Fees

 

Example 2:

Going to an Urgent Care (UCC) for treatment of Flu Symptoms

  • You Pay - $59*
  • Florida Blue Covers - $99*

Going to an ER for treatment of Flu Symptoms

  • You Pay - $765*
  • Florida Blue Covers - $1,367*

Note: ER cost includes Facility Fees

 

What types of virtual care are available?

Virtual visits

Ask your Florida Blue provider if they offer virtual visits. These appointments give you the opportunity to receive ongoing care from your regular doctor when an in-person visit isn’t required or possible. Receive the care you need, all while social distancing.

Teladoc available 24/7

Talk to a doctor within minutes, even after hours and on weekends. Skip the waiting room and talk to a health care professional by phone or video 24/7.

If you get your health plan through your employer, check with your primary care doctor, behavioral health provider or specialist to see if they offer virtual care. And, be sure to check your cost share. With a virtual visit, you may be able to get care wherever you are for as low as a $0 copay. If your doctor isn’t available, you may be able to use Teladoc, the nation’s largest virtual health care company. Check with human resources to verify your plan’s benefits.

If you buy your own plan for you and your family, virtual visits with designated primary care doctors and 24/7 care with Teladoc are available for a $0 out-of-pocket cost with most plans. Ask your doctor if they offer virtual visits.

To contact Teladoc, you can download the mobile app or call 800-TELADOC.

 

 

*These are examples based on averages of all claims from in-network providers for commercial Florida Blue products in the year 2020 and are not specific to any plan.  Members should refer to their plan benefits for more details regarding appropriate member liability for specific services.

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