BlueChoice AdvantageSM, one of our open access plans, gives you freedom to visit doctors, even specialists, at your option. Unlike our Primary Choice plan, you don't have to choose a primary care physician or get a referral to see a contracting specialist. You must visit doctors, specialists, hospitals and other health care professionals that are in our statewide network, however, in order to receive benefits. Using network participants saves time and effort. They will:
- File claims for covered expenses for you.
- Ask you to only pay the copayment, deductible and coinsurance amounts, if any, for covered expenses.
- Accept our payment as payment in full for covered expenses, minus the out-of-pocket expense, if any.
BlueChoice Advantage covers medically necessary services we list in the contract we sign with each employer. Most contracts include these services:
- Physician and hospital services.
- Urgent and emergency care.
- Prescription drugs at low copayments.
- Mental health and substance abuse treatment.
- Physical, speech and occupational therapy.
- Ambulance service.
- Dental services needed for accidental injury.
- Durable medical equipment, supplies and original prosthetic appliances.
- Home health and hospice care.
- Routine vision and dental care.
Just remember — we will cover services, including preventive care, only when you visit a network provider. For more details on what we cover, please check your schedule of benefits. You can also see our Member Guide. To learn more, please call our Marketing department at 800-327-3183.
You can also view a sample of the Certificate of Coverage.