People enrolled in Blue Cross and Blue Shield of Missouri/Alliance Blue Cross Blue Shield's preferred provider organization (PPO) programs can now obtain the highest level of benefits when they use other Blue Cross and Blue Shield PPO providers throughout the nation through the BlueCard PPO program, according to a news release from Alliance.
"The BlueCard PPO gives us a coast-to-coast network," said Michael Fulk, senior vice president and chief marketing officer, Alliance Blue Cross Blue Shield, in the release.
"Our members who live in or travel to other service areas can receive full benefits through Blue Cross and Blue Shield PPOs across the United States. And we offer a national PPO network to employers who have employees at many locations throughout the country."
BlueCard is the Blue Cross and Blue Shield Association program that allows Blue Cross and Blue Shield PPO members access to Blue Cross and Blue Shield PPO providers throughout the nation. Blue Cross and Blue Shield PPO networks are available to 95 percent of the U.S. population.
Blue Cross and Blue Shield of Missouri, the parent company of Alliance Blue Cross Blue Shield, received approval to offer the program in early May to group and individual members of Alliance and AllianceChoice.
Members with individual programs had access to BlueCard PPO benefits beginning July 1. New groups received access beginning Aug. 1, and renewing groups received access as they renewed on or after Aug. 1, Alliance stated.
Members who need to see a doctor or check into a hospital while living in or traveling to another part of the country will be able to do so and not pay more out of pocket for being out of the service area's network while accessing Blue Cross PPO providers.
Here's how the program works: A member who is living or traveling in another city needs to go to the doctor. That member finds out which doctor is in the local Blue Cross and Blue Shield PPO program by calling the BlueCard number on the back of the Alliance Blue Cross Blue Shield ID card, or the member can request a provider directory from the local plan. The member then heads to the doctor.
The local Blue Cross Plan receives the claim from the provider, applies the PPO discount and sends the claim to Alliance Blue Cross Blue Shield. Employees at Alliance Blue Cross Blue Shield look at the claim, make sure the membership is up to date and apply that member's benefits, sending the member an explanation of benefits and providing reimbursement information to the out-of-area Blue Cross Plan so that it can pay the provider. Members receive in-network benefits for an out-of-area visit, thus receiving the highest level of benefits.
At this time, 49 Blue Cross and Blue Shield Plans representing 5 million-plus members participate in the program. About 300,000 Alliance and AllianceChoice members will be added to the program during the coming year.
"With a nation of people who travel a great deal for business or pleasure, BlueCard is a great program to offer," Fulk said. "And large, multi-state employers will be able to offer their employees the same, hassle-free benefits regardless of where they live."
The BlueCard PPO program will also be of value to families with children away at school, Fulk stated. "Families will be able to stick to one health benefits plan and not have to find health care coverage for children living away at college," he said.
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