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Cover Florida for Individuals

What is Cover Florida?

If you're one of the 3.8 million Floridians between the ages of 19 and 64 currently without health coverage, Cover Florida was designed just for you. Working under Governor Crist's Cover Florida Health Care Access initiative, BCBSF created two affordable health care plans that provide coverage for eligible individuals regardless of your medical conditions or health status.

Cover Florida Plan I is a limited benefit plan focused on preventive and routine care including coverage for physician and specialist services, urgent care center visits and lab work. Plan II, also a limited benefit plan, combines preventive and routine care with hospital and surgical coverage. Both offer prescription drug coverage and basic and preventive dental benefits including twice annual cleanings, oral exams and more. The best part is, there are no medical tests or histories to provide, and you are guaranteed enrollment after you meet just a few eligibility requirements.

You can visit any provider you want, in- or out-of-network. By seeing a NetworkBlue provider (in-network), you'll get a discounted rate because our providers have agreed to charge you less than what they normally would charge.


Am I eligible for Cover Florida?

While Cover Florida is a health plan that doesn't require medical tests or health questions, there are a few eligibility requirements:

  • You must be a Florida resident between the ages 19 and 64
  • Have been without health insurance for six months or longer (there are a few exceptions so please call our licensed agents toll-free at 1-877-872-6580 for assistance)
  • Are not eligible for any public health insurance programs (such as Medicaid)

Cover Florida plans are only offered to individuals, so your spouse must qualify for his or her own plan separately.

Gender:  

Date of Birth: (Month, Day, Year)

      (YYYY)

Zip Code: 

County:

For security purposes, please enter the 4 digit code below for verification:

  




Which Plan is Right for Me?

The best plan for you depends on how much coverage you need. Compare the benefits below, but please refer to the complete benefit summaries for Plan I (PDF) and Plan II (PDF) to make an informed decision and to see the out-of-network coverage. This is only a partial description of the many benefits and services available.

Cover Florida Plan I
Limited Benefit Plan		 Plan II
Limited Benefit Plan with
Hospital and Surgical Services
Cost Sharing Benefits (In-Network)
Calendar Year Deductible (CYD) $0 $3,000
Coinsurance (amount you pay) 0% 20%
Other Benefits (In-Network)
Physician or Specialist Office Services We pay $50 or the allowed amount, whichever is lower, and you pay the difference between the allowed amount and our maximum payment amount. We pay $50 or the allowed amount, whichever is lower, and you pay the difference between the allowed amount and our maximum payment amount.
Adult Wellness (includes well woman, routine adult physicals, immunizations and non-invasive colorectal or prostate screenings) We pay $50 or the allowed amount, whichever is lower, and you pay the difference between the allowed amount and our maximum payment amount. We pay $50 or the allowed amount, whichever is lower, and you pay the difference between the allowed amount and our maximum payment amount.
Mammograms 100% Covered if you stay in-network 100% Covered if you stay in-network
Colonoscopy (routine for age 50+ then frequency schedule applies) We pay $50 or the allowed amount, whichever is lower, and you pay the difference between the allowed amount and our maximum payment amount. We pay $50 or the allowed amount, whichever is lower, and you pay the difference between the allowed amount and our maximum payment amount.
Inpatient Hospital Facility Services (per admission) Not Covered CYD plus coinsurance
Outpatient Hospital Facility Services (services related to surgery only) Not Covered CYD plus coinsurance
Hospital & ER Physician Services Not Covered CYD plus coinsurance
Urgent Care Centers We pay $50 or the allowed amount, whichever is lower, and you pay the difference between the allowed amount and our maximum payment amount. For non-surgical services, we pay $50 or the allowed amount, whichever is lower, and you pay the difference between the allowed amount and our maximum payment amount.

For surgical services, CYD plus coinsurance.
Emergency Room Facility Services (per visit) Not Covered CYD plus coinsurance
Independent Clinical Lab 100% Covered if you use Quest Diagnostics. 100% Covered if you use Quest Diagnostics.
Rx Benefits We pay $15 or the allowed amount, whichever is lower, and you pay the difference between the allowed amount and our maximum pharmacy payment amount. We pay $15 or the allowed amount, whichever is lower, and you pay the difference between the allowed amount and our maximum pharmacy payment amount.
Dental Benefits (Preventive and Basic Dental Services) We pay $50 or the allowed amount, whichever is lower, and you pay the difference between the allowed amount and our maximum payment amount. We pay $50 or the allowed amount, whichever is lower, and you pay the difference between the allowed amount and our maximum payment amount.
Benefit Maximums (In-Network)
Lifetime Maximum (per Individual) No Maximum $50,000
Annual Maximum (per Individual) No Maximum $25,000
View Benefit Summary »
(PDF)		 View Benefit Summary »
(PDF)


How Do I Apply for Cover Florida?

It's as easy as 1 – 2 – 3. Determine your premium amount, complete the application and mail your application and payment to us!

  1. Use the Get a Quote feature to figure out your monthly premium. Be sure to write down the plan and the rate for the plan you want to purchase since you will need this information for your application.
  2. Fill out the application (PDF). Be sure you answer every question and the information you provide us is accurate and complete, your enrollment will go faster that way. You can either type your information into the document or print the application and fill it out by hand.
  3. Send your application, disclosure form and payment to: Blue Cross and Blue Shield of Florida, PO Box 45074, Jacksonville FL 32232-5016.
Be sure to include your check for your initial payment!   We won't be able to process your application
without it.

And that's all there is to do. Once we receive your application and initial payment, we'll process it and – provided there are no problems with your application or payment – you'll be enrolled in Cover Florida. This usually takes 7 to 10 days after we receive your application.


Have Questions About Cover Florida?





Cover Florida is a limited health benefit plan, which does not include all required benefit mandates as provided under Florida law.

These plans have limitations and exclusions. The premium and the amount of benefits provided depend upon the plan you select and your age.

The balance is the difference between BCBSF's payment and the amount an in-network provider (under Cover Florida) agrees to accept as payment in full for covered services. If you choose to visit a doctor or provider that is not in the network for Cover Florida, the balance is their charge to you for the covered services minus BCBSF's payment. You are responsible for paying the doctor or provider this balance.

NetworkBlue is made up of independent contracting hospitals, physicians and ancillary providers.


 
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