To get the most value from your plan, it’s important to understand how it works and where to go for care.
Where do I go for care?
Your myBlue Connected Care PCP is your partner in health. That doctor, or another in the same medical group, should always be your first call when you need medical care. They can provide most of the services you’ll need or refer you to a specialist, clinic, hospital or other facility, if needed. With myBlue Connected Care, if you don’t start with your assigned PCP, you may have to pay the entire cost of the visit.
How do I find who my primary care doctor (PCP) is?
If you haven’t already chosen a PCP from the myBlue Connected Care network, you’ll find that we have matched you with a doctor from a Sanitas Medical Center near you. That’s because your plan’s benefits work best, and you get more perks when you have a Sanitas doctor. You can find your doctor’s name and contact information when you log in to your member account at floridablue.com or through the Florida Blue app.
Do I have to use my assigned doctor?
Yes, always contact your assigned PCP first when you need medical care. You can change to a different PCP in the myBlue Connected Care network anytime. The new doctor must show as your PCP in our system before your visit in order for your plan to cover the cost of that visit.
If you go to a doctor outside your network, or you don’t wait until the new doctor you chose is updated in your member account, you may have to pay the full cost of the visit.
What if I want a second opinion about a recommended procedure?
If you need surgery or therapy and you want a second opinion, ask your PCP for a referral.
Do I need to be pre-approved before seeing a specialist?
Yes. If you need to see a medical specialist, your PCP will refer you to one. Without this pre-approval, your plan won’t cover the visit, and you may have to pay the full amount of the specialist visit.
Does myBlue Connected Care cover urgent care visits?
Yes. You’ll have two (2) in-person urgent care visits at no additional cost when you see your Sanitas doctor or another one in the same practice.1 Unlike otherurgent care centers, Sanitas urgent care centers have your medical history on file and they’ll follow up after your visit to ensure you’re getting better. Even if you’re out-of-state, you’ll be covered for emergency care.
To find an urgent care center close to you, click here.
When should I choose my primary care doctor (PCP), an urgent care clinic or the ER?
If it’s not an emergency, your PCP should be your first choice when seeking care. They can treat common illnesses (cold, flu, sore throat, etc.),minor injuries and conduct routine exams, vaccinations and screenings.
If you need care right away, use these guidelines to help decide where to go for care.
Urgent care centers are less expensive than ERs and often have shorter wait times. Visit an urgent care center for conditions like:
- Cold and flu-like symptoms
- Migraines
- Sinus infection
- Urinary tract infection
- Upper respiratory infections
- Low back pain, strains, sprains and/or breaks
- Mild burns
In a life-threatening emergency, always call 911 or go to the nearest ER. Examples of symptoms that require ER care include:
- Severe chest pain (a possible heart attack)
- Signs of a possible stroke
- Severe or sudden shortness of breath
- Sudden or unexplained loss of consciousness
Manage your health plan on the go at floridablue.com or on the Florida Blue mobile app!
- Got a question? Our new virtual assistant will answer your questions 24/7 in English and Spanish.
- You can pay your bill, check benefits, see your health savings account balance and even make appointments with some doctors whenever it’s convenient for you.
- If you have a PCP from Sanitas, you can connect with your Sanitas doctor in just a few clicks from your member account!
1 Urgent care visits at $0 do not apply to Health Savings Account (HSA) plans; the deductible will still apply. A total of two (2) urgent care visits are $0 for non-HSA plans regardless of which Value Choice Provider rendered services. After that, the urgent care cost share applies. Value Choice Provider is a designation Florida Blue HMO gives to some in-network providers, including Sanitas.
