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BlueJourney HMO

Select a BlueJourney HMO plan that meets your needs.

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Service Area
BlueJourney Premier HMO
BlueJourney Value HMO
BlueJourney Essential HMO

Enroll Online Enroll Online Enroll Online
Monthly Premium $106 $51 $0
Deductible $0 $0 $0
Primary Care Physician Office Visits - in person or telehealth $5 copay $5 copay $5 copay
Specialist Office Visits - in person or telehealth $20 copay $30 copay $30 copay
Urgent Care $30 copay $50 copay $40 copay
Inpatient Hospital Stay $80 per day for days 1-5 $135 per day for days 1-5 $190 per day for days 1-8
Ambulatory Surgical Center (ASC) $75 copay $200 copay $250 copay
Outpatient Surgery $225 copay $300 copay $350 copay
Emergency Care - copay waived if admitted $120 copay $90 copay $90 copay
Labs $10 copay $5 copay $10 copay
X-rays Outpatient x-rays $25 copay Outpatient x-rays $25 copay Outpatient x-rays $50 copay
Diagnostic Radiology - not including x-rays $75 copay $150 copay $250 copay
Diabetes Self-Monitoring Training and Supplies $0 copay per item $0 copay per item $0 copay per item
Hearing Services $0 copay for routine exam and fitting, Limit 1 exam per calendar year ($800 allowance every 3 years for hearing aids) $0 copay for routine exam and fitting, Limit 1 exam per calendar year ($800 allowance every 3 years for hearing aids) $0 copay for routine exam and fitting, Limit 1 exam per calendar year ($800 allowance every 3 years for hearing aids)
Routine Vision Services

$20 copay

One eye exam every calendar year

$125 allowance towards eyeglass frames or contact lenses every 2 years

$20 copay

One eye exam every calendar year

$125 allowance towards eyeglass frames or contact lenses every 2 years

$20 copay

One eye exam every calendar year

$125 allowance towards eyeglass frames or contact lenses every 2 years

Expanded Dental Benefits $10 copay (includes 2 cleanings, bitewing x-rays (set of two), oral exam) $10 copay (includes 2 cleanings, bitewing x-rays (set of two), oral exam) $10 copay (includes 2 cleanings, bitewing x-rays (set of two), oral exam)
SilverSneakers® Fitness Benefit $0 copay $0 copay $0 copay
Durable Medical Equipment 20% coinsurance 20% coinsurance 20% coinsurance
Prescription Drug Benefits $0 deductible $0 deductible $0 deductible
Over-the-counter $25 monthly allowance for over-the-counter (OTC) drugs and supplies. Unused allowance may not be carried over from one month to the next.  $25 monthly allowance for over-the-counter (OTC) drugs and supplies. Unused allowance may not be carried over from one month to the next.  $25 monthly allowance for over-the-counter (OTC) drugs and supplies. Unused allowance may not be carried over from one month to the next. 
Transportation Benefit

24 plan approved round trips

24 plan approved round trips

24 plan approved round trips

Meals Benefit – Post Hospital Discharge 2 meals per day for 7 days 2 meals per day for 7 days 2 meals per day for 7 days
In-home Support Services: Grandkids on Demand 5 hours per month included 5 hours per month included Not included
Medical Nutritional Therapy $0 copay $0 copay $0 copay
Nutritional/Dietary Benefit $0 copay $0 copay $0 copay
Virtual Care $0 copay $0 copay $0 copay
Health Coaching and Education Benefit $0 copay $0 copay $0 copay

Enroll Online

Other Ways to Enroll

Enroll Online

Other Ways to Enroll

Enroll Online

Other Ways to Enroll

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Updated October 1, 2020

Y0016_WBST21_M

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