Provider: Blue Cross and Blue Shield of Florida and OptumRx
Pre-Enroll help line: 877-705-5429 | Customer Service: 855-212-4674
MyHealthToolkitFL.com
Which Medical Plan is Right?
You have two BCBS FL medical plan options: the High Deductible Health Plan (HDHP) and the PPO plan.
Review The Plans. Review both plans to better understand what features the plans have in common and what is different.
Evaluate Your Needs. Consider your prior health care usage and select plans and options that fit your lifestyle and needs.
- Do you take regular prescription medications?
- Are you anticipating surgery or non-preventive dental care?
- Did you experience a qualifying life event this year?
- Review your current plans to ensure you have the coverage you need.
A little bit of planning will help you select the best plans, coverage levels, and financial programs for your unique situation.
Contact the BCBS Pre-Enrollment Help Line at 877-705-5429 for help before enrolling.
Use Network based on where you reside: Georgia residents (RTK – Blue Open Access POS), Florida residents (RTL – Network Blue), All other states (RTC – Blue Choice PPO)
Medical Plan Comparison
Both the PPO and HDHP:
- Cover the same medical services (including in-network preventive services at no cost).
- Offer prescription drug coverage
- Use the same BCBS provider network and prescription network.
- Feature Teladoc services for: General Medical, Mental Health, and Dermatology.
- Offer My Health Novel programs (Weight Management, Musculoskeletal Management, and Behavioral Health Management) that support your overall health and wellbeing, at no cost!
Key Differences1
Both plans cover the same services and offer savings by using BCBS FL contracted providers, who have agreed to charge lower, contracted rates (known as in-network rates) to members for services.
The primary differences between the plans are in what you pay out of your paycheck for coverage and how much you pay when you get care.
1 These assume you are using in-network providers that charge lower negotiated rates than out-of-network providers. If you use out-of-network providers, you’ll pay more for care and prescription drugs. For more information about out-of-network coverage, see the Summary of Benefits Coverage in UKG Pro > Myself > Benefits > Manage My Benefits.
Benefit Exclusive to the HDHP Only!
There are a variety of drugs and services that are covered 100% as preventive care. This coverage extends to many conditions, including heart disease, asthma, depression, liver disease, and more. For example, no-cost A1c testing and insulin medication that may be prescribed to help manage diabetes.
For more details, see list below. List can also be accessed in UKG Pro > Myself >Benefits > Manage My Benefits > Documents or by logging into MyHealthToolKitFL.com.
Roper Tech Preventive Drug List
Medical Care & Prescriptions
Below is a summary of the BCBS PPO and HDHP plan in-network benefits. If you use out-of-network providers, you’ll pay more for care and prescription drugs.
2 90-day supply is available at in-network retail pharmacies and through OptumRx Home Delivery for two times the cost of a 30-day supply.
3 For those with single coverage: on a biweekly payroll basis, the per payday amount is $26.92; semi-monthly per payday amount is $29.17; weekly per payday amount is $13.46 for those with single coverage. For those with family coverage: on a biweekly payroll basis, the per payday amount is $46.15; semi-monthly per payday amount is $50.00; weekly per payday amount is $23.08 for those with single coverage.
Prescription: Generic Incentive Program
To save more on prescription drug costs, take advantage of the generic incentive program in both the BCBS PPO and HDHP plans. If you or your doctor request a brand-name drug when a generic equivalent is available, you will pay the brand copay or coinsurance (depending on your plan), plus the difference in cost between the generic drug and the brand drug. You will never pay more than the actual cost of the brand drug.
Your BCBS secure, online health care site. Sign up to have access on the go!
- Verify medical and prescription eligibility and benefits.
- Research specific health issues.
- Find doctors, hospitals, and pharmacies.
- Estimate medical and prescription costs.
- Find additional discounts and perks available to members only!
Find the BCBS/OptumRx Drug Lists:
Log in to MyHealthToolKitFL.com. Or, on the website click on Prescription Drugs to view the Lowest Net Cost formulary.
Find BCBS In-Network Providers:
Log in to MyHealthToolKitFL.com. Or, on the website click on Find Care, and use the Network based on where you reside: Georgia residents (RTK – Blue Open Access POS), Florida residents (RTL – Network Blue), All other states (RTC – Blue Choice PPO)
2025 BCBS FL Guidebook
BCBS Global Core
BCBS Transition of Care Form (new enrollees)
BCBS Provider Flyer – Members
BCBS Provider Flyer – Non-Members
Video: HDHP vs PPO
Video: HDHP with HSA
Questions? Please click on Contacts & Resources for help.