![]() All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure. Before making a final decision, please read the Plan’s federal brochure (RI 71-005). This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. applies only to services available through Anthem Blue Cross and Blue Shield. The formulary and/or pharmacy network may change at any time. 1 Coverage for non-emergency care when traveling outside the U.S. Enrollment in MPDP depends on contract renewal. ![]() The FEP Medicare Prescription Drug Program is a prescription drug plan with a Medicare contract. 3 You must be the contract holder or spouse, 18 or older, on a Standard or Basic Option Plan to earn incentive rewards.2 If you have Medicare Part B primary, your costs for prescription drugs may be lower.1 Under Basic Option you pay 30% of our allowance for agents, drugs and/or supplies you receive during your care.^ What you’ll pay for a 30-day supply of covered drugs.Under Basic Option, benefits are not available for services performed by Non-preferred providers, except in certain situations such as emergency care.Ĭost sharing may not apply or may be different if Medicare is your primary coverage (it pays first). Tier 4 (Preferred specialty): $85 copay 2 Visit the Medicare page for more information. Tier 5 (Non-preferred specialty): $110 copay 2Īvailable to members with Medicare Part B primary only. Tier 4 (Preferred specialty): $85 copay 2 Tier 3 (Non-preferred brand): 60% of our allowance ( $90 minimum) 2 $0 for first 2 visits and all nutrition visits Some Blue Cross and Blue Shield companies also offer a toll-free 24-hour nurse line, which you can find on the back of your member card, or by visiting your BCBS company website.Nothing for covered preventive screenings, immunizations and services If you feel your condition doesn’t require the emergency room, call your personal physician or go to a walk-in clinic or urgent care center. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. (medical emergency) 30 : of our allowance: 250: per day per facility : 15: of our allowance Lab work. Emergency room copayments or coinsurance will cost you far more, likely between $100-$300. copay : Specialists 40: copay: 1 : 35: copay : Mental health visits 30: copay: 1 : 25. Office visit copayments or coinsurance typically cost around $10-$30. What's more, you'll pay far more out-of-pocket for emergency room care. They face long waits for care they could receive more quickly in a physician’s office. However, every year millions of Americans use the emergency room for routine medical care. It may seem obvious, but emergency rooms are not the place for routine care. In some cases, such as a stroke or heart attack, delays in treatment often lead to more serious consequences. If you feel it’s an emergency, act quickly – don’t hesitate. Or call the 1-800 number on the back of your member card. You can also find in-network doctors and hospitals with our provider directory. Need help finding a physician? Read our Five Tips for Choosing a New Primary Care Physician. It’s one of the main benefits of having a physician who knows you.” Your physician’s office or on-call service is trained to guide you through these events. Don’t hesitate when it comes to calling your personal physician in urgent care situations. “You should be able to talk to your personal physician about anything. According to Gutshall, if you don’t have a personal physician, make it a priority to find one. Tim Gutshall, family physician and chief medical officer at Wellmark Blue Cross and Blue Shield. Having a relationship with a personal physician is the most important thing you can do for your health,” says Dr. You can also find additional suggestions on how to choose where to go to seek treatment for common health problems on. Below, The Blues® offer some guidance on how to determine the right destination for your treatment needs. There are three places available for you to seek care: your physician’s office, an urgent-care or walk-in clinic, or the emergency room. (You can find out more about your coverage by calling the number on the back of your member card or by visiting your BCBS company website.) We know you don’t expect to get sick, or anticipate an accidental injury or life-threatening health event, but when an ailment strikes knowing where to go can help relieve some of the worry and stress. ![]() The answer is putting your insurance to use. When If you’re one of the millions of Americans with a new Blue Cross Blue Shield health insurance plan, congratulations! You’ve successfully enrolled with the oldest and largest health insurance network in America and can enjoy the security of unparalleled access to quality, affordable healthcare.
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