BasicBlue Direct
5500/11000
A plan that covers office visits and generic drugs before the deductible while also providing comprehensive coverage after you meet the deductible. You have access to our national network of doctors, labs, and hospitals, with no referral required.
- Provides coverage for most office visits and generic drugs before deductible
- Access to 95% of doctors and hospitals across 50 states
- MedsYourWay® prescription savings program—no coupons or discount cards needed—and all covered prescription purchases accumulate toward your deductible (if applicable) and out-of-pocket maximum.*
- Certain over-the-counter preventive medications cost $0 when purchased at a participating pharmacy with a prescription
- Earn up to $250 (both subscriber and covered spouse) in wellness rewards
- Member discounts with Blue 365 on gyms, nutrition services, fitness trackers, and more health and lifestyle brands
- Free dental exam and cleaning for members under 19
- View benefit information on myBCBSRI
- Full coverage for many preventive services, like an annual physical, when you use a doctor in the national network
- $0 copays for programs on quitting smoking, weight loss, and managing conditions like diabetes
What's covered
See if your doctor is in the network
Search providers
Coverage
In-Network You Pay
Medical Coverage
Preventive services
$0
Primary care provider (PCP) office visit when affiliated with a patient-centered medical home (PCMH)
$10
PCP not affiliated with a PCMH
$20
Doctors Online (designated telemedicine provider)
$20
Retail clinic
$45
Specialist visit
$45
Acupuncture treatment
$45 after deductible (12 visits per year)
Urgent care center
$75 after deductible
Emergency room
10% after deductible
Diagnostic laboratory tests
10% after deductible
X-rays
10% after deductible
High-end radiology (MRI, PET, CAT scan, etc.)
10% after deductible
Inpatient hospital
10% after deductible
Pediatric Vision Eyeware (Dependents under 19)
Collection prescription glasses, lenses, and collection contact lenses
10% after deductible
Pediatric Dental (Dependent under 19)
Oral exams, cleanings, X-rays, fluoride treatments, sealants, and space maintainers
$0
All other covered dental services
50% after deductible
Coverage
In-Network You Pay
Tier 1 (Preferred Generic)
$10
Tier 2 (Non-preferred Generic)
$30
Tier 3 (Preferred Brand)
$50 after deductible
Tier 4 (Non-Preferred Brand)
$75 after deductible
Tier 5 (Specialty)
20% coinsurance after deductible
*MedsYourWay is not insurance. It is a drug discount program administered by Prime Therapeutics, LLC, an independent company contracted by BCBSRI to provide pharmacy benefit management services. Ask your pharmacy if they participate in MedsYourWay before filling your prescription.