VantageBlue Direct
6000/12000
This plan gives you the highest levels of coverage and flexibility to choose what doctors you see. You will have access to our national network of doctors (across all 50 states), labs, and hospitals, with no referral required.
- Provides coverage for most office visits before deductible
- Full coverage for many preventive services, like an annual physical, when you use a doctor in the national network
- 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.*
- Includes dental and vision coverage for dependents under the age of 19
- $2 copays for certain prescription drugs used to treat diabetes, asthma, and chronic obstructive pulmonary disorders (COPD)
- $0 copays for an annual foot and eye exam for members with diabetes
- $0 copays for programs on quitting smoking, weight loss, and managing conditions like diabetes
- 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
- COMING IN JANUARY 2025: BlueCare Connect, your new online member account, is your front door to everything healthcare
What's covered
See if your doctor is in the network
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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)
$40 (first sick visit is free)
PCP not affiliated with a PCMH
$60 (first sick visit is free)
Doctors Online (designated telemedicine provider)
$40
Retail clinic
$50
Specialist visit
$65
Acupuncture treatment
$45 (12 visits per year)
Annual foot and eye exam for members with diabetes
$0
Urgent care center
$75
Emergency room
$475
Diagnostic laboratory tests
30% after deductible
X-rays
30% after deductible
High-end radiology (MRI, PET, CAT scan, etc.)
30% after deductible
Inpatient hospital
30% after deductible
Pediatric Vision Eyeware (Dependents under 19)
Collection prescription glasses, lenses, and collection contact lenses
$0
Pediatric Dental (Dependent under 19)
Oral exams, cleanings, X-rays, fluoride treatments, sealants, and space maintainers
$0
All other covered dental services
50%
Coverage
In-Network You Pay
Tier 1 (Preferred Generic)
$10
Tier 2 (Non-preferred Generic)
$35
Tier 3 (Preferred Brand)
$80
Tier 4 (Non-Preferred Brand)
$100
Tier 5 (Specialty)
$150 after deductible
Certain maintenance prescriptions for diabetes, asthma, and chronic obstructive pulmonary disease (COPD)
$2
*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.