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Blue Dimensions Office Visit with Pharmacy Integrated Benefit

To locate your specific Summary of Benefits and Coverage, identify your Deductible, Coinsurance, and Out of Pocket amounts for your plan.

BD = Blue Dimensions
OVC = Office Visit Copay
Ded = Deductible
Coin = Coinsurance
OOP = Out of Pocket
PIB = Pharmacy Integrated Benefit

 2012 Summary of Benefits and Coverage

$15 OVC
$25 OVC
$35 OVC

 2013 Summary of Benefits and Coverage

$15 OVC
$25 OVC
$35 OVC
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