Blue Choice Select      
  Other Carrier Marketing Materials
Humana | IAC | Starmark | Time | Trustmark | UnitedHealthcare

PPO | BlueEdge HSA | PPO Value Choice | HMO | HMO Value Choice | Blue Choice Select
Dental | Licensing | Vision
   
 
  All Plans Marketed 7/1/07 and Later

*7/1/08 Effective Dates
  The Following Plans are Serviced by the 10/20/35 Drug Card
Plan Deductible Co-Insurance Co-Pay Download
42322 $250 90/60 $20 English
72322 $500 90/60 $20 English
82322 $1000 90/60 $20 English
92322 $1500 90/60 $20 English
C2322 $2500 90/60 $20 English
43432 $250 80/50 $30 English
73432 $500 80/50 $30 English
83432 $1000 80/50 $30 English
93432 $1500 80/50 $30 English
C3432 $2500 80/50 $30 English
*E2322 $3500 90/60 $20 English
*E3432 $3500 80/50 $30 English
   
  The Following Plans are Serviced by the 15/30/50 Drug Card
Plan Deductible Co-Insurance Co-Pay Download
42323 $250 90/60 $20 English
72323 $500 90/60 $20 English
82323 $1000 90/60 $20 English
92323 $1500 90/60 $20 English
C2323 $2500 90/60 $20 English
43433 $250 80/50 $30 English
73433 $500 80/50 $30 English
83433 $1000 80/50 $30 English
93433 $1500 80/50 $30 English
C3433 $2500 80/50 $30 English
*E2323 $3500 90/60 $20 English
*E3433 $3500 80/50 $30 English
   
  The Following Plans are Serviced by the 10/40/60 Drug Card
Plan Deductible Co-Insurance Co-Pay Download
42326 $250 90/60 $20 English
72326 $500 90/60 $20 English
82326 $1000 90/60 $20 English
92326 $1500 90/60 $20 English
C2326 $2500 90/60 $20 English
43436 $250 80/50 $30 English
73436 $500 80/50 $30 English
83436 $1000 80/50 $30 English
93436 $1500 80/50 $30 English
C3436 $2500 80/50 $30 English
*E2326 $3500 90/60 $20 English
*E3436 $3500 80/50 $30 English
  All Plans Marketed Prior to 7/1/07
  The Following Plans are Serviced by the 10/20/35 Drug Card
Plan Deductible Co-Insurance Co-Pay Download
42322 $250 90/60 $20 English
72322 $500 90/60 $20 English
82322 $1000 90/60 $20 English
92322 $1500 90/60 $20 English
C2322 $2500 90/60 $20 English
43432 $250 80/50 $30 English
73432 $500 80/50 $30 English
83432 $1000 80/50 $30 English
93432 $1500 80/50 $30 English
C3432 $2500 80/50 $30 English
   
  The Following Plans are Serviced by the 15/30/50 Drug Card
Plan Deductible Co-Insurance Co-Pay Download
42323 $250 90/60 $20 English
72323 $500 90/60 $20 English
82323 $1000 90/60 $20 English
92323 $1500 90/60 $20 English
C2323 $2500 90/60 $20 English
43433 $250 80/50 $30 English
73433 $500 80/50 $30 English
83433 $1000 80/50 $30 English
93433 $1500 80/50 $30 English
C3433 $2500 80/50 $30 English
   
  The Following Plans are Serviced by the 15/30%/50% Drug Card
Plan Deductible Co-Insurance Co-Pay Download
42324 $250 90/60 $20 English
72324 $500 90/60 $20 English
82324 $1000 90/60 $20 English
92324 $1500 90/60 $20 English
C2324 $2500 90/60 $20 English
43434 $250 80/50 $30 English
73434 $500 80/50 $30 English
83434 $1000 80/50 $30 English
93434 $1500 80/50 $30 English
C3434 $2500 80/50 $30 English
 
  All Plans Marketed Prior to 1/1/06
  The Following Plans are Serviced by the 10/20/35 Drug Card
Plan Deductible Co-Insurance Co-Pay Download
42322 $250 90/60 $20 English
72322 $500 90/60 $20 English
82322 $1000 90/60 $20 English
92322 $1500 90/60 $20 English
C2322 $2500 90/60 $20 English
43432 $250 80/50 $30 English
73432 $500 80/50 $30 English
83432 $1000 80/50 $30 English
93432 $1500 80/50 $30 English
C3432 $2500 80/50 $30 English
   
  The Following Plans are Serviced by the 15/30/50 Drug Card
Plan Deductible Co-Insurance Co-Pay Download
42323 $250 90/60 $20 English
72323 $500 90/60 $20 English
82323 $1000 90/60 $20 English
92323 $1500 90/60 $20 English
C2323 $2500 90/60 $20 English
43433 $250 80/50 $30 English
73433 $500 80/50 $30 English
83433 $1000 80/50 $30 English
93433 $1500 80/50 $30 English
C3433 $2500 80/50 $30 English
   
  The Following Plans are Serviced by the 15/30%/50% Drug Card
Plan Deductible Co-Insurance Co-Pay Download
42324 $250 90/60 $20 English
72324 $500 90/60 $20 English
82324 $1000 90/60 $20 English
92324 $1500 90/60 $20 English
C2324 $2500 90/60 $20 English
43434 $250 80/50 $30 English
73434 $500 80/50 $30 English
83434 $1000 80/50 $30 English
93434 $1500 80/50 $30 English
C3434 $2500 80/50 $30 English