DIMITRI MICHAEL TSALICKIS DO
Accepted Insurance Health Plans for NPI 1700373669
Internal Medicine in New Port Richey, FL
NPI Status: Active since April 17, 2018
Contact Information
11178 STATE ROAD 54 STE A
NEW PORT RICHEY, FL
ZIP 34655
Phone: (727) 372-4200
Fax: (727) 333-6371
Accepted Health Plans and Insurance Coverage
List of insurance companies accepted by DIMITRI MICHAEL TSALICKIS DO. Use our filterable tables to quickly find the details of your health plan, including: Plan Name, Plan Type and Plan ID. Search this page to find if your specific insurance is accepted. Please verify directly with the provider to make sure your healthplan is currently accepted.
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160054 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 18628FL0160060 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160022 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160061 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 18628FL0160062 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160055 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 18628FL0160063 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160030 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160064 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 18628FL0160065 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160029 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision | HMO | 18628FL0160067 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Complete Gold | HMO | 49004FL0010011 | No |
| Complete Gold | HMO | 49004FL0010025 | No |
| Complete Gold + Vision + Adult Dental | HMO | 49004FL0020010 | No |
| Complete Gold + Vision + Adult Dental | HMO | 49004FL0020021 | No |
| Elite Bronze | HMO | 49004FL0010004 | No |
| Elite Bronze | HMO | 49004FL0010017 | No |
| Elite Bronze + Vision + Adult Dental | HMO | 49004FL0020004 | No |
| Elite Bronze + Vision + Adult Dental | HMO | 49004FL0020015 | No |
| Elite Silver | HMO | 49004FL0010008 | No |
| Elite Silver | HMO | 49004FL0010020 | No |
| Elite Silver + Vision + Adult Dental | HMO | 49004FL0020007 | No |
| Elite Silver + Vision + Adult Dental | HMO | 49004FL0020017 | No |
| Enhanced Diabetes Care Silver with $0 Drug Options | HMO | 49004FL0010009 | No |
| Enhanced Diabetes Care Silver with $0 Drug Options | HMO | 49004FL0010023 | No |
| Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental | HMO | 49004FL0020008 | No |
| Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental | HMO | 49004FL0020020 | No |
| Everyday Bronze | HMO | 49004FL0010002 | No |
| Everyday Bronze | HMO | 49004FL0010015 | No |
| Everyday Bronze + Vision + Adult Dental | HMO | 49004FL0020002 | No |
| Everyday Bronze + Vision + Adult Dental | HMO | 49004FL0020013 | No |
| Everyday Gold | HMO | 49004FL0010010 | No |
| Everyday Gold | HMO | 49004FL0010026 | No |
| Everyday Gold + Vision + Adult Dental | HMO | 49004FL0020009 | No |
| Everyday Gold + Vision + Adult Dental | HMO | 49004FL0020022 | No |
| Focused Silver | HMO | 49004FL0010007 | No |
| Focused Silver | HMO | 49004FL0010021 | No |
| Focused Silver + Vision + Adult Dental | HMO | 49004FL0020006 | No |
| Focused Silver + Vision + Adult Dental | HMO | 49004FL0020018 | No |
| Standard Expanded Bronze | HMO | 49004FL0010001 | No |
| Standard Expanded Bronze | HMO | 49004FL0010018 | No |
| Standard Expanded Bronze + Vision + Adult Dental | HMO | 49004FL0020001 | No |
| Standard Expanded Bronze + Vision + Adult Dental | HMO | 49004FL0020016 | No |
| Standard Gold | HMO | 49004FL0010013 | No |
| Standard Gold | HMO | 49004FL0010028 | No |
| Standard Gold + Vision + Adult Dental | HMO | 49004FL0020012 | No |
| Standard Gold + Vision + Adult Dental | HMO | 49004FL0020024 | No |
| Standard Silver | HMO | 49004FL0010006 | No |
| Standard Silver | HMO | 49004FL0010024 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Complete Gold | EPO | 53932AL0100015 | No |
| Complete Gold + Vision + Adult Dental | EPO | 53932AL0110010 | No |
| Elite Bronze | EPO | 53932AL0100014 | No |
| Elite Bronze + Vision + Adult Dental | EPO | 53932AL0110014 | No |
| Elite Gold | EPO | 53932AL0100016 | No |
| Elite Gold + Vision + Adult Dental | EPO | 53932AL0110015 | No |
| Elite Silver | EPO | 53932AL0100017 | No |
| Elite Silver + Vision + Adult Dental | EPO | 53932AL0110016 | No |
| Everyday Bronze | EPO | 53932AL0100003 | No |
| Everyday Bronze + Vision + Adult Dental | EPO | 53932AL0110003 | No |
| Focused Silver | EPO | 53932AL0100005 | No |
| Focused Silver + Vision + Adult Dental | EPO | 53932AL0110005 | No |
| Standard Expanded Bronze | EPO | 53932AL0100011 | No |
| Standard Expanded Bronze + Vision + Adult Dental | EPO | 53932AL0110011 | No |
| Standard Gold | EPO | 53932AL0100013 | No |
| Standard Gold + Vision + Adult Dental | EPO | 53932AL0110013 | No |
| Standard Silver | EPO | 53932AL0100012 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| AvMed Entrust Bronze 600 (2025) | HMO | 19898FL0340006 | No |
| AvMed Entrust Bronze 600 (2025) | HMO | 19898FL0340016 | No |
| AvMed Entrust Bronze 600 (2025) | HMO | 19898FL0340026 | No |
| AvMed Entrust Bronze 600 (2025) | HMO | 19898FL0340036 | No |
| AvMed Entrust Bronze 600 (2025) | HMO | 19898FL0340046 | No |
| AvMed Entrust Bronze 650 (2025) | HMO | 19898FL0340007 | No |
| AvMed Entrust Bronze 650 (2025) | HMO | 19898FL0340017 | No |
| AvMed Entrust Bronze 650 (2025) | HMO | 19898FL0340027 | No |
| AvMed Entrust Bronze 650 (2025) | HMO | 19898FL0340037 | No |
| AvMed Entrust Bronze 650 (2025) | HMO | 19898FL0340047 | No |
| AvMed Entrust Expanded Bronze Standard (2025) | HMO | 19898FL0340091 | No |
| AvMed Entrust Expanded Bronze Standard (2025) | HMO | 19898FL0340092 | No |
| AvMed Entrust Expanded Bronze Standard (2025) | HMO | 19898FL0340093 | No |
| AvMed Entrust Expanded Bronze Standard (2025) | HMO | 19898FL0340094 | No |
| AvMed Entrust Expanded Bronze Standard (2025) | HMO | 19898FL0340095 | No |
| AvMed Entrust Gold 125 (2025) | HMO | 19898FL0340001 | No |
| AvMed Entrust Gold 125 (2025) | HMO | 19898FL0340011 | No |
| AvMed Entrust Gold 125 (2025) | HMO | 19898FL0340021 | No |
| AvMed Entrust Gold 125 (2025) | HMO | 19898FL0340031 | No |
| AvMed Entrust Gold 125 (2025) | HMO | 19898FL0340041 | No |
| AvMed Entrust Gold 125 Dental+Vision (2025) | HMO | 19898FL0350001 | No |
| AvMed Entrust Gold 125 Dental+Vision (2025) | HMO | 19898FL0350011 | No |
| AvMed Entrust Gold 125 Dental+Vision (2025) | HMO | 19898FL0350021 | No |
| AvMed Entrust Gold 125 Dental+Vision (2025) | HMO | 19898FL0350031 | No |
| AvMed Entrust Gold 125 Dental+Vision (2025) | HMO | 19898FL0350041 | No |
| AvMed Entrust Gold Standard (2025) | HMO | 19898FL0340071 | No |
| AvMed Entrust Gold Standard (2025) | HMO | 19898FL0340072 | No |
| AvMed Entrust Gold Standard (2025) | HMO | 19898FL0340073 | No |
| AvMed Entrust Gold Standard (2025) | HMO | 19898FL0340074 | No |
| AvMed Entrust Gold Standard (2025) | HMO | 19898FL0340075 | No |
| AvMed Entrust Platinum 25 (2025) | HMO | 19898FL0340020 | No |
| AvMed Entrust Platinum 25 (2025) | HMO | 19898FL0340061 | No |
| AvMed Entrust Platinum 25 (2025) | HMO | 19898FL0340064 | No |
| AvMed Entrust Platinum 25 Dental+Vision (2025) | HMO | 19898FL0350020 | No |
| AvMed Entrust Platinum 25 Dental+Vision (2025) | HMO | 19898FL0350061 | No |
| AvMed Entrust Platinum 25 Dental+Vision (2025) | HMO | 19898FL0350064 | No |
| AvMed Entrust Platinum Standard (2025) | HMO | 19898FL0340062 | No |
| AvMed Entrust Platinum Standard (2025) | HMO | 19898FL0340063 | No |
| AvMed Entrust Platinum Standard (2025) | HMO | 19898FL0340065 | No |
| AvMed Entrust Silver 350 (2025) | HMO | 19898FL0340003 | No |
| AvMed Entrust Silver 350 (2025) | HMO | 19898FL0340013 | No |
| AvMed Entrust Silver 350 (2025) | HMO | 19898FL0340023 | No |
| AvMed Entrust Silver 350 (2025) | HMO | 19898FL0340033 | No |
| AvMed Entrust Silver 350 (2025) | HMO | 19898FL0340043 | No |
| AvMed Entrust Silver 350 Dental+Vision (2025) | HMO | 19898FL0350003 | No |
| AvMed Entrust Silver 350 Dental+Vision (2025) | HMO | 19898FL0350013 | No |
| AvMed Entrust Silver 350 Dental+Vision (2025) | HMO | 19898FL0350023 | No |
| AvMed Entrust Silver 350 Dental+Vision (2025) | HMO | 19898FL0350033 | No |
| AvMed Entrust Silver 350 Dental+Vision (2025) | HMO | 19898FL0350043 | No |
| AvMed Entrust Silver 550 (2025) | HMO | 19898FL0340005 | No |
| AvMed Entrust Silver 550 (2025) | HMO | 19898FL0340015 | No |
| AvMed Entrust Silver 550 (2025) | HMO | 19898FL0340025 | No |
| AvMed Entrust Silver 550 (2025) | HMO | 19898FL0340035 | No |
| AvMed Entrust Silver 550 (2025) | HMO | 19898FL0340045 | No |
| AvMed Entrust Silver 550 Dental+Vision (2025) | HMO | 19898FL0350005 | No |
| AvMed Entrust Silver 550 Dental+Vision (2025) | HMO | 19898FL0350015 | No |
| AvMed Entrust Silver 550 Dental+Vision (2025) | HMO | 19898FL0350025 | No |
| AvMed Entrust Silver 550 Dental+Vision (2025) | HMO | 19898FL0350035 | No |
| AvMed Entrust Silver 550 Dental+Vision (2025) | HMO | 19898FL0350045 | No |
| AvMed Entrust Silver Standard (2025) | HMO | 19898FL0340081 | No |
| AvMed Entrust Silver Standard (2025) | HMO | 19898FL0340082 | No |
| AvMed Entrust Silver Standard (2025) | HMO | 19898FL0340083 | No |
| AvMed Entrust Silver Standard (2025) | HMO | 19898FL0340084 | No |
| AvMed Entrust Silver Standard (2025) | HMO | 19898FL0340085 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) | PPO | 16842FL0260010 | No |
| BlueOptions Bronze 24J01-04 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) | PPO | 16842FL0260004 | No |
| BlueOptions Bronze 24J01-06 ($0 Virtual PCP Visits / Rewards) | PPO | 16842FL0260006 | No |
| BlueOptions Bronze 24J01-17 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) | PPO | 16842FL0260017 | No |
| BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards) | PPO | 16842FL0260018 | No |
| BlueOptions Gold 24J01-09 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) | PPO | 16842FL0260009 | No |
| BlueOptions Gold 24J01-12 ($0 Virtual PCP Visits / $15 Labs / Rewards) | PPO | 16842FL0260012 | No |
| BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards) | PPO | 16842FL0260020 | No |
| BlueOptions Platinum 24J01-05 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) | PPO | 16842FL0260005 | No |
| BlueOptions Platinum 24J01-08 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) | PPO | 16842FL0260008 | No |
| BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) | PPO | 16842FL0260021 | No |
| BlueOptions Silver 24J01-03 ($0 Virtual PCP Visits / $0 Labs / Rewards) | PPO | 16842FL0260003 | No |
| BlueOptions Silver 24J01-07 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) | PPO | 16842FL0260007 | No |
| BlueOptions Silver 24J01-19S ($40 PCP Visits / Multilingual Available / Rewards) | PPO | 16842FL0260019 | No |
| BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx) | EPO | 16842FL0120078 | No |
| BlueSelect Bronze 1449 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) | EPO | 16842FL0120068 | No |
| BlueSelect Bronze 2139 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) | EPO | 16842FL0120091 | No |
| BlueSelect Bronze 2139E ($0 Virtual PCP Visits / $50 PCP Visits / Adult Dental & Vision / Rewards) | EPO | 16842FL0320014 | No |
| BlueSelect Bronze 2139V ($0 Virtual PCP Visits / $50 PCP Visits / Adult Vision / Rewards) | EPO | 16842FL0310014 | No |
| BlueSelect Bronze 2342S ($50 PCP Visits / Multilingual Available / Rewards) | EPO | 16842FL0120093 | No |
| BlueSelect Bronze 24L01-01 ($0 Virtual PCP Visits / Rewards) | EPO | 16842FL0120001 | No |
| BlueSelect Gold 1535 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) | EPO | 16842FL0120076 | No |
| BlueSelect Gold 1535V ($0 Virtual PCP Visits / $15 PCP Visits / Adult Vision / Rewards) | EPO | 16842FL0310001 | No |
| BlueSelect Gold 1835 ($0 Virtual PCP Visits / $15 Labs / Rewards) | EPO | 16842FL0120086 | No |
| BlueSelect Gold 2344S ($30 PCP Visits / Multilingual Available / Rewards) | EPO | 16842FL0120095 | No |
| BlueSelect Platinum 1451 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) | EPO | 16842FL0120062 | No |
| BlueSelect Platinum 1457 ($0 Deductible / $0 Virtual PCP Visits / $10 PCP Visits / Rewards) | EPO | 16842FL0120070 | No |
| BlueSelect Platinum 2345S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) | EPO | 16842FL0120096 | No |
| BlueSelect Silver 1443 ($0 Virtual PCP Visits / $0 Labs / Rewards) | EPO | 16842FL0120072 | No |
| BlueSelect Silver 1443E ($0 Virtual PCP Visits / $0 Labs / Adult Dental & Vision / Rewards) | EPO | 16842FL0320004 | No |
| BlueSelect Silver 1443V ($0 Virtual PCP Visits / $0 Labs / Adult Vision / Rewards) | EPO | 16842FL0310004 | No |
| BlueSelect Silver 1456 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) | EPO | 16842FL0120033 | No |
| BlueSelect Silver 2343S ($40 PCP Visits / Multilingual Available / Rewards) | EPO | 16842FL0120094 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) | POS | 30252FL0140009 | No |
| BlueCare Bronze 24K01-03 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) | POS | 30252FL0140003 | No |
| BlueCare Bronze 24K01-05 ($0 Virtual PCP Visits / Rewards) | POS | 30252FL0140005 | No |
| BlueCare Bronze 24K01-25 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) | POS | 30252FL0140025 | No |
| BlueCare Bronze 24K01-31S (Multilingual Available / Rewards) | POS | 30252FL0140031 | No |
| BlueCare Bronze 24K02-17 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) | POS | 30252FL0140017 | No |
| BlueCare Bronze 24K02-18 ($0 Virtual PCP Visits / Rewards) | POS | 30252FL0140018 | No |
| BlueCare Bronze 24K02-23 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) | POS | 30252FL0140023 | No |
| BlueCare Bronze 24K02-26S (Multilingual Available / Rewards) | POS | 30252FL0140026 | No |
| BlueCare Gold 24K01-08 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) | POS | 30252FL0140008 | No |
| BlueCare Gold 24K01-10 ($0 Virtual PCP Visits / $15 Labs / Rewards) | POS | 30252FL0140010 | No |
| BlueCare Gold 24K01-33S ($30 PCP Visits / Multilingual Available/ Rewards) | POS | 30252FL0140033 | No |
| BlueCare Gold 24K02-20 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) | POS | 30252FL0140020 | No |
| BlueCare Gold 24K02-28S ($30 PCP Visits / Multilingual Available / Rewards) | POS | 30252FL0140028 | No |
| BlueCare Platinum 24K01-04 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) | POS | 30252FL0140004 | No |
| BlueCare Platinum 24K01-07 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) | POS | 30252FL0140007 | No |
| BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) | POS | 30252FL0140034 | No |
| BlueCare Platinum 24K02-15 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) | POS | 30252FL0140015 | No |
| BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) | POS | 30252FL0140029 | No |
| BlueCare Silver 24K01-02 ($0 Virtual PCP Visits / $0 Labs / Rewards) | POS | 30252FL0140002 | No |
| BlueCare Silver 24K01-06 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) | POS | 30252FL0140006 | No |
| BlueCare Silver 24K01-32S ($40 PCP Visits / Multilingual Available / Rewards) | POS | 30252FL0140032 | No |
| BlueCare Silver 24K02-21 ($0 Virtual PCP Visits / $0 Labs / Rewards) | POS | 30252FL0140021 | No |
| BlueCare Silver 24K02-27S ($40 PCP Visits / Multilingual Available / Rewards) | POS | 30252FL0140027 | No |
| myBlue Bronze 1601 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $45 / Rewards) | HMO | 30252FL0070001 | No |
| myBlue Bronze 2013 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $30 / Rewards) | HMO | 30252FL0070025 | No |
| myBlue Bronze 2129 ($0 Virtual PCP Visits / $35 PCP Visits / $75 Specialist Visits / Rewards) | HMO | 30252FL0070031 | No |
| myBlue Bronze 2129E ($0 Virtual PCP Visits / $35 PCP Visits / $75 Specialist Visits / Adult Dental & Vision / Rewards) | HMO | 30252FL0200009 | No |
| myBlue Bronze 2129V ($0 Virtual PCP Visits / $35 PCP Visits / $75 Specialist Visits / Adult Vision / Rewards) | HMO | 30252FL0190009 | No |
| myBlue Bronze 2149 ($0 Virtual PCP Visits / $35 PCP Visits / $75 Specialist Visits / Rewards) | HMO | 30252FL0070033 | No |
| myBlue Bronze 2149E ($0 Virtual PCP Visits / $35 PCP Visits / $75 Specialist Visits / Adult Dental & Vision / Rewards) | HMO | 30252FL0200010 | No |
| myBlue Bronze 2149V ($0 Virtual PCP Visits / $35 PCP Visits / $75 Specialist Visits / Adult Vision / Rewards) | HMO | 30252FL0190010 | No |
| myBlue Bronze 2219 ($0 Virtual PCP Visits / Rewards) | HMO | 30252FL0070039 | No |
| myBlue Bronze 2286 ($0 Virtual PCP Visits / Rewards) | HMO | 30252FL0070041 | No |
| myBlue Bronze 2312S ($50 PCP Visits / Multilingual Available / Rewards) | HMO | 30252FL0070044 | No |
| myBlue Bronze 2322S ($50 PCP Visits / Multilingual Available / Rewards) | HMO | 30252FL0070045 | No |
| myBlue Bronze 2329 ($0 Virtual PCP Visits / $75 PCP Visits / Rewards) | HMO | 30252FL0070046 | No |
| myBlue Bronze 2329E ($0 Virtual PCP Visits / $75 PCP Visits / Adult Dental & Vision / Rewards) | HMO | 30252FL0200022 | No |
| myBlue Bronze 2329V ($0 Virtual PCP Visits / $75 PCP Visits / Adult Vision / Rewards) | HMO | 30252FL0190018 | No |
| myBlue Bronze 2349 ($0 Virtual PCP Visits / $75 PCP Visits / Rewards) | HMO | 30252FL0070036 | No |
| myBlue Connected Care Silver 24M03-70 ($0 Virtual PCP Visits / $0 Primary Care Visits with Select Providers / 24x7 Provider Access / Rewards) | HMO | 30252FL0070070 | No |
| myBlue Gold 1605 ($0 Virtual PCP Visits / $0 Labs / Rewards) | HMO | 30252FL0070009 | No |
| myBlue Gold 2011 ($0 Virtual PCP Visits / $0 Labs / Rewards) | HMO | 30252FL0070023 | No |
| myBlue Gold 2016 ($0 Deductible / $0 Virtual PCP Visits / Rewards) | HMO | 30252FL0070028 | No |
| myBlue Gold 2314S ($30 PCP Visits / Multilingual Available / Rewards) | HMO | 30252FL0070055 | No |
| myBlue Gold 2325S ($30 PCP Visits / Multilingual Available / Rewards) | HMO | 30252FL0070056 | No |
| myBlue Gold 24M05-74 ($0 Deductible / $0 Virtual PCP Visits / Rewards) | HMO | 30252FL0070074 | No |
| myBlue Platinum 2015 ($0 Deductible / $0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) | HMO | 30252FL0070027 | No |
| myBlue Platinum 2324S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) | HMO | 30252FL0070058 | No |
| myBlue Platinum 24M05-00S ($0 Deductible / $10 PCP Visits / Multilingual Available / Rewards) | HMO | 30252FL0070100 | No |
| myBlue Platinum 24M05-75 ($0 Deductible / $0 Virtual PCP Visits / $0 Labs / Rewards) | HMO | 30252FL0070075 | No |
| myBlue Silver 2010 ($0 Virtual PCP Visits / Rewards) | HMO | 30252FL0070022 | No |
| myBlue Silver 2010E ($0 Virtual PCP Visits / Adult Dental & Vision / Rewards) | HMO | 30252FL0200003 | No |
| myBlue Silver 2010V ($0 Virtual PCP Visits / Adult Vision / Rewards) | HMO | 30252FL0190003 | No |
| myBlue Silver 2237 ($0 Virtual PCP Visits / $60 PCP Visits / $20 Labs / Rewards) | HMO | 30252FL0070035 | No |
| myBlue Silver 2237E ($0 Virtual PCP Visits / $60 PCP Visits / $20 Labs / Adult Dental & Vision / Rewards) | HMO | 30252FL0200011 | No |
| myBlue Silver 2237V ($0 Virtual PCP Visits / $60 PCP Visits / $20 Labs / Adult Vision / Adult Vision / Rewards) | HMO | 30252FL0190011 | No |
| myBlue Silver 2313S ($40 PCP Visits / Multilingual Available / Rewards) | HMO | 30252FL0070053 | No |
| myBlue Silver 2323S ($40 PCP Visits / Multilingual Available / Rewards) | HMO | 30252FL0070054 | No |
| myBlue Silver 24M02-78 ($0 Virtual PCP Visits / $50 PCP Visits / $15 Labs / Rewards) | HMO | 30252FL0070078 | No |
| myBlue Silver 24M02-78E ($0 Virtual PCP Visits / $50 PCP Visits / $15 Labs / Adult Dental & Vision / Rewards) | HMO | 30252FL0200032 | No |
| myBlue Silver 24M02-78V ($0 Virtual PCP Visits / $50 PCP Visits / $15 Labs / Adult Vision / Rewards) | HMO | 30252FL0190028 | No |
| myBlue Silver 24M03-70E ($0 Virtual PCP Visits / $0 Primary Care Visits with Select Providers / Adult Dental & Vision / Rewards) | HMO | 30252FL0200029 | No |
| myBlue Silver 24M03-70V ($0 Virtual PCP Visits / $0 Primary Care Visits with Select Providers / Adult Vision / Rewards) | HMO | 30252FL0190025 | No |
| myBlue Silver 24M06-76 ($0 Virtual PCP Visits / $50 PCP Visits / $10 Labs / Rewards) | HMO | 30252FL0070076 | No |
| myBlue Silver 24M06-76E ($0 Virtual PCP Visits / $50 PCP Visits / $10 Labs / Adult Dental & Vision / Rewards) | HMO | 30252FL0200034 | No |
| myBlue Silver 24M06-76V ($0 Virtual PCP Visits / $50 PCP Visits / $10 Labs / Adult Vision / Rewards) | HMO | 30252FL0190030 | No |
| myBlue Silver 25M02-03 ($0 Virtual PCP Visits / $0 Labs / $50 PCP Visits / Rewards) | HMO | 30252FL0070103 | No |
| myBlue Silver 25M02-03E ($0 Virtual PCP Visits / $0 Labs / $50 PCP Visits / Adult Dental & Vision / Rewards) | HMO | 30252FL0200038 | No |
| myBlue Silver 25M02-03V ($0 Virtual PCP Visits / $0 Labs / $50 PCP Visits / Adult Vision / Rewards) | HMO | 30252FL0190034 | No |
| myBlue Silver 25M03-01 ($0 Virtual PCP Visits / $0 Primary Care Visits with Select Providers / $20 Labs / Rewards) | HMO | 30252FL0070101 | No |
| myBlue Silver 25M03-01E ($0 Virtual PCP Visits / $0 Primary Care Visits with Select Providers / $20 Labs / Adult Dental & Vision / Rewards) | HMO | 30252FL0200036 | No |
| myBlue Silver 25M03-01V ($0 Virtual PCP Visits / $0 Primary Care Visits with Select Providers / $20 Labs / Adult Vision / Rewards) | HMO | 30252FL0190032 | No |
| myBlue Silver 25M06-02 ($0 Virtual PCP Visits / $0 Labs / $50 PCP Visits / Rewards) | HMO | 30252FL0070102 | No |
| myBlue Silver 25M06-02E ($0 Virtual PCP Visits / $0 Labs / $50 PCP Visits / Adult Dental & Vision / Rewards) | HMO | 30252FL0200037 | No |
| myBlue Silver 25M06-02V ($0 Virtual PCP Visits / $0 Labs / $50 PCP Visits / Adult Vision / Rewards) | HMO | 30252FL0190033 | No |