Blue Choice Options

Blue Cross Blue Shield Health Plans give individuals the option of choosing where to receive services and at what level the claims are to be paid. BlueChoice Options Plans cover most individuals' health care needs. There are three options from which to choose: the BlueChoice Component Plan; In-Network in which services are provided from a preferred provider; and out-of-network.

BlueChoice Component

• BlueChoice allows a member's primary care physician (PCP) to coordinate his care, obtain any authorizations needed and file claims on the patient's behalf. With this option, the highest level of benefits are received with the smallest co-pays and deductibles.

In-Network From a Preferred Provider

• The in-network or preferred provider option allows individuals to receive services from a provider that participates in the provider network. This requires a slightly higher co-payment and deductible, and may have more limited maximums (services that have a maximum limit of benefits placed on them, for example, chiropractic may have a 20-visit maximum per calendar year) than the BlueChoice option.

Out-of-Network

• Individuals using the out-of-network option will be responsible for a higher deductible. Usually, payment for services is due at the time the services are rendered, with a credit given if payment should exceed the bill. Reasons this may occur include if a patient's deductible has been met or a portion there of that has not been indicated yet because the claim has not been processed prior to the patients current services and therefore not applied to the deductible. Benefits may be limited or maximums smaller than the other two options.

Important Facts

• When choosing a BlueChoice plan, it is important to get the information for the state or area that the individual resides in. Benefits vary per state/area and per the administrator of the plan. Contact your local BlueChoice plan to apply or receive information regarding the premiums and benefits.