Group Plan Overview

HSA BlueCare (High Deductible HMO)

is a high-deductible HMO plan. Members must choose primary care physicians (PCPs) who help coordinate care. Referrals to specialists within the HMO network are not required.

Benefits are paid at 80% or 100% of the allowed price after members meet ­annual deductibles. Office visits for preventive care, including well-child care, are covered in full.

Learn more about HSAs

HSA Blue (High Deductible PPO)

is a high-deductible plan that allows members to use providers of their choice, an attractive option for those who live or work outside of Vermont. If the chosen provider does not participate with the patient's local Blue Cross and blue Shield, the patient may be balanced billed.

Once a member meets the annual deductible, benefits are paid at 80% or 100% of the Allowed Price, depending on the plan.

Learn more about HSAs

 BlueCare Access HSA

is a high-deductible plan ideal for Vermont-based employers that employ out-of-state staff because the group can offer a single health plan to all employees, regardless of where they reside.  Members who reside in the BlueCare service area (i.e., Vermont and the bordering counties of New Hampshire) use TVHP providers while out-of-area residents access health care through the national BlueCard network.

Benefits are paid at 80% or 100% of the allowed price after members meet ­annual deductibles. Office visits for preventive care, including well-child care, are covered in full.

NOTE:  Eligibility  requirements include residency limits.

Learn more about HSAs

BlueCare (HMO)

is a managed care plan that requires members to select primary care physicians (PCPs). Referrals to specialists within the HMO network are not required.

Members pay only co-payments for PCP office visits and pay nothing at all for preventive office visits, including annual OB-GYN exams and Well-Child Care. Hospital inpatient care, outpatient care or specialist visits may require larger co-payments or deductibles.

Some limits and requirements apply. No benefits are paid when members do not follow the guidelines for managed care.

 BlueCare Access (HMO)

offers members the same quality care and low-cost co-payments of our managed care products but delivers network access locally and across the country.

This plan is ideal for Vermont-based employers that employ out-of-state staff because the group can offer a single health plan to all employees, regardless of where they reside.  Members who reside in the BlueCare service area (i.e., Vermont and the bordering counties of New Hampshire) use TVHP providers while out-of-area residents access health care through the national BlueCard network.

Members pay only co-payments for PCP office visits and pay nothing at all for preventive office visits, including annual OB-GYN exams and Well-Child Care. Hospital inpatient care, outpatient care or specialist visits may require larger co-payments or deductibles.

Some limits and requirements apply. No benefits are paid when members do not follow the guidelines for managed care.

NOTE:  Eligibility  requirements include residency limits.

The Vermont Freedom Plan (VFP) (PPO)

is a preferred provider organization (PPO) product with two levels of benefits. The plan offers lower out-of-pocket expenses when members seek care from preferred providers within the Blue Cross and Blue Shield of Vermont network or with preferred networks in other states. The plan pays a standard level of benefits with higher out-of-pocket costs when members receive care from non-preferred providers, and may be balanced billed.

The national network of providers is an attractive option for those who live or work outside of Vermont.

BlueCare Options (POS)

is a point-of-service (POS) plan that offers the same in-network benefits as our HMO plans, but provides a second, “standard” level of benefits for employees who want the flexibility of seeking care and services outside of the HMO network.

Standard benefits require members to share more in the cost of their care through deductibles and coinsurance, but the option gives members peace of mind. Some benefits must be rendered in-network.

Vermont Health Partnership (POS)VHP

is a point-of-service, managed care plan with no referrals necessary. Members get most of their care from network physicians and pay  co-payments. Employees who follow managed care guidelines receive preferred benefits.

Employees who choose not to follow managed care guidelines may receive standard benefits for certain services, but they must pay deductibles and share in expenses through coinsurance.