Your insurance needs are as unique as you are. You may meet your deductible each year, or maybe you can’t remember the last time you saw a doctor. The Standard Plan is one of two State Health Plan options, and has higher premiums and lower deductibles. BlueCross BlueShield of South Carolina (BlueCross) is the third-party administrator for the State Health Plan.
A copayment is the fixed amount you pay for a covered health care service or drug. You will pay a copayment for prescription drugs, office visits, emergency care and outpatient facility services. Copayments do not apply to your annual deductible or your coinsurance maximum. After you meet your annual deductible, and even after you reach your coinsurance maximum, you will continue to pay copayments.
A deductible is the amount you pay for covered services before your health plan begins to pay. The Standard Plan has individual deductibles and family deductibles. When one family member meets his deductible, the Standard Plan will begin to pay benefits for him even if the family deductible has not been met.
Prescription drug coverage
Prescription benefits are included with Standard Plan coverage. You will pay a copayment for prescription drugs, up to $3,000 per year. Prescription drugs are covered only at network pharmacies. Express Scripts is the pharmacy benefits manager.
You can learn more about the Standard Plan in the Insurance Benefits Guide.
You can enroll during:
- Your initial enrollment;
- Open enrollment in October; or
- A special eligibility situation.
Coverage with Medicare
Information about how the Standard Plan coordinates with Medicare is available in the Insurance Coverage for the Medicare-eligible Member handbook.
After your initial enrollment, you will receive two identification cards from BlueCross. You can also access your digital identification card from the My Health Toolkit mobile app. If you need to order a replacement card, visit StateSC.SouthCarolinaBlues.com or call BlueCross at 888.214.6230. You will need your Benefits Identification Number (BIN). If you don’t know your BIN, log in to MyBenefits and select Get My BIN.