Making Healthy Cheaper
Health Coverage

Current & Former Employee Coverage & Rates for the 2023/24 Plan Year, effective 7/1/2023 through 6/30/2024.
   665.38    Member
   317.88    Child
   517.50    Children
   777.98    Spouse
   1,095.86    Spouse & Child
   1,295.48    Spouse & Children
Free care available from BlueDistinction+ Centers Only
   Free    Transplants
   Free    Cancer Care - Coming Soon
   Free    Cardiac Care
   Free    Spinal Care
   Free    Hip & Knee Care
   Free    Maternity Care
Resource Links
   BlueDistinction Provider Search  
   Cardiac Care Procedure Codes  
   Spinal Care Procedure Codes  
   Hip & Knee Care Procedure Codes  
   Single Page Flyer  
   Free    Cash Rewards  
   Free    Medical Equipment & Supplies  
   Free    Primary & Pediatric Care  
   Free    Psychiatry & Counseling Care  
   Free    Mental Health Support Programs  
   Free    Muscle & Joint Pain Program  
   Free    Diabetes Program  
   Free    Hypertension Program  
   Free    Cholesterol Program  
   Free    Asthma & COPD Program  
   Free    Alcohol Addiction Program  
   Free    Opioid Addiction Program  
   Free    Tobacco & Vaping Addiction Program  
   Free    Fitness & Wellness Program  
   Free    Weight-Loss Program  
   Free    In-Home Sleep Studies  
   Free    Women's & Family Support Programs  
   Free    OTC Acid-Reflux & GERD Medications
   $5    OTC Antihistamine Medications
   Free    Tobacco & Smoking Cessation Medications
   $25    Insulin - Preferred Brands
   $5    Diabetic Oral Generic Medications
   $500    for Dependent Accident Claims  
   50%    Dependent Deductible Reimbursement  
   Vendor:    BlueCross BlueShield
   Network:    BluePreferred
   Customer Service:    800 313 5162
Personal Support When You & Your Family Need It Most
What is a Health Advocate?
   Provides access to you and your dependents to an all-around benefits specialist and personal health care resources
   Health Advocates are more than just customer service personnel, they are part of a dedicated support team
   The health advocate is assigned to you and your covered family members
   This way, you will have a familiar person to talk to whenever you may have a question, concern or health issue needing to be addressed
How Do You Reach a Health Advocate?
   Availability:    Monday – Friday, 7am – 7pm CST
   Phone:    800 313 5162
   Text:    BCBSOKAPP** to 33633 to download the App
   App Store:    Search for BCBSOKAPP on the Apple App Store or Google Play Store
What Can a Health Advocate Assist You With?
   Access to Programs/Services
   Medical Information
   Claims History/Status
   Benefit Details
   Claims Questions
   Health Care Support
   Navigation Guidance
   Cost Estimates for Services
   Wellness Resources
   Personal Holistic Care
   Support for Behavioral Health Issues
   Managing a Chronic Condition or Health Concern
   Specialized Clinician Support
Who's Part of the Health Advocate Support Team?
   Registered Nurse (RN)
   Behavioral Health Specialist
   Holistic Health Advisor
   Social Workers
   Medical Doctor
When Do Health Advocates Reach Out Directly to You?
   Health Event/Chronic Condition
   New Diagnosis
   Finding Care
   Virtual Visits Guidance
   Connectivity with Other Programs/Services
The following Out-of-Pocket costs apply to covered benefits received from BluePreferred network providers.
   $1,750    Deductible - Individual
   $3,500    Deductible - Family
   $6,000    Maximum Out-of-Pocket - Individual
   $12,000    Maximum Out-of-Pocket - Family
   20%    Co-Insurance
   Preventive Services  
Office Visit Co-Pays only apply to the Office Visit charge.
Additional charges received during an Office Visit are subject to Deductible & Co-Insurance.
   Free    Virtual Primary & Pediatric Care - MDLIVE  
   $25    In-Person Primary & Pediatric Care Co-Pay
   Free    Virtual Counseling & Psychiatry - MDLIVE  
   Free    Virtual Urgent Care - MDLIVE  
   $25    In-Person Urgent Care Co-Pay
   $50    In-Person Specialist Care Co-Pay
   $50    Emergency Room Co-Pay (Waived if Admitted)
The following Out-of-Pocket costs apply to covered benefits received from Out-of-Network providers.
Amounts paid towards Out-of-Network Deductible and Maximum Out-of-Pocket do not count towards In-Network amounts and vice versa.
   $3,500    Deductible - Individual
   $7,000    Deductible - Family
   $12,000    Maximum Out-of-Pocket - Individual
   $24,000    Maximum Out-of-Pocket - Family
   30%    Co-Insurance of Allowable Cost
   100%    Balance Billing for Amounts Over Allowable Cost
   $1,000    In-Patient Pre-Authorization Penalty Deductible
         Per admission when using an Out-of-Network Provider and Pre-Authorization is not obtained, as required.
         Waived if admission is Pre-Authorized by the Claims Administrator.
         Does not apply towards the Maximum Out-of-Pocket.
   Vendor:    Express Scripts (ESI)
   Network:    National Preferred Formulary
   Customer Service:    855 315 2460
   Specialty Pharmacy:    800 803 2523
The following Out-of-Pocket costs apply to prescription medications received from In-Network pharmacies
   $100    Deductible per Individual applies to Brand Names only
   $2,500    Maximum Out-of-Pocket - Individual
   $5,000    Maximum Out-of-Pocket - Family
30-Day Supply
For 90-Day Supply, Multiply by 2.5
   $10 Generics   
   25% up to a maximum of $80    Preferred Brands
   40% up to a maximum of $120    Non-Preferred Brands
30-Day Supply
   $10    Generics
   $60    Preferred Brands
   $100    Non-Preferred Brands
30-Day Supply
   Free    Contraceptives & Contraceptive Devices
   Free    Tobacco Quitting Solutions
   Free    GERD & Acid Reflux Over-The-Counter (OTC) Medications
         Includes: Nexium, Prevacid, Prilosec, Protonix, Omeprazole & Zegerid
   $5    Antihistamine Over-The-Counter (OTC) Medications
         Includes: Alavert, Claritin, Flonase, Mucinex, Nasacort, Nasonex & Zyrtec
   $5    Diabetic Generic Oral Medications
   $25    Insulin - Select Brands Only