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Benefits are determined according to the terms of your plan. If you have questions about availability of benefits for a specific service, please contact the BCBS Customer Service Center at 1-877-238-5951 and speak with a Customer Service Representative.
You will receive the lower level of benefit for non-network doctors. Ask your doctor to help you find an in-network specialist. Remember you do not need referrals from your primary care doctor; you may see any specialist and if you use a PPO specialist, your benefits will be paid at a higher level.
Expenses and charges over the reasonable and customary limits do not apply to your annual deductible or out-of-pocket maximum.
As a BCBS member, you have access to the BlueCard® PPO network, which links you to a network of doctors and hospitals throughout the United States. You also have access when traveling or working abroad to BlueCard Worldwide® doctors and hospitals in more than 200 countries.
If you receive care from a non-Blue Cross Blue Shield Global® Core doctor or hospital, your benefits will be paid at the PPO level (80%).
You need to pre-notify any inpatient hospital care and pre-notify some outpatient hospital procedures. In addition, infertility services must be pre-notified.
The following services require pre-notification:
Before any scheduled inpatient hospitalization and within 2 business days of an emergency hospitalization, members must call Customer Service at 1-877-238-5951 to pre-notify the hospitalization with Blue Care Connection. This call can be made by:
Members who do not make the call — or have it made on their behalf — for an inpatient stay within the appropriate time frame will be assessed a $250 charge.
In the event of a medical emergency, call 911. You should seek treatment at the nearest facility. For emergency care, benefits will be paid at the in-network benefit level, regardless of the facility used.
For each visit to the emergency room, you will be responsible for paying a $200 copayment. The emergency room visit charge is waived if the patient is admitted to the hospital from the emergency room. It is not applied to the deductible or toward satisfying the out-of-pocket expense limits.
A medical emergency is generally defined as a medical condition that has symptoms of an injury or illness serious enough to make you, as a prudent layperson with an average knowledge of health and medicine, believe that any delay in seeking care may result in significant impairment or death.
Call Caremark with questions about prescription drug benefits at 1-855-298-2488. Caremark automated services are available 24 hours a day, 7 days a week. For more information, visit Caremark.
Review a summary of your behavioral health care benefits or contact Live and Work Well with questions at 1-855-809-2013 (access code: abbvie), Monday through Friday, 7 a.m. to 7 p.m., Central time.
You can reach BCBS Customer Service at 1-877-238-5951. Customer Service Representatives are available Monday – Friday, 7 a.m. to midnight CT, and Saturday, 8 a.m. to 6 p.m. CT.
You can check claim status several different ways. You can call Customer Service toll-free at 1-877-238-5951. They can advise you on the status of any processed claims, as well as those that are still being considered. To check claim status, log on to Blue Access for Members.
Most doctors are familiar with the BlueCard® program and know how to file claims. The doctor should follow the filing instructions on the back of your member ID card, which states all claims should be filed with their local Blue Cross and Blue Shield plan.
Once your claim has been processed, you’ll receive an Explanation of Benefits (EOB) from Blue Cross and Blue Shield of Illinois. The EOB will provide details of what was covered, the level of coverage, and the amount you owe. To view your EOBs online, log on to Blue Access for Members.
Your local Blue Cross and Blue Shield plan will not be able to assist you. BCBS Customer Service for AbbVie employees is trained on your plan's benefits and will be able to assist you with questions regarding the processing of your claims. To ensure you receive a prompt and accurate response to any questions you may have regarding your claims or benefits, please contact BCBS Customer Service at 1-877-238-5951.
When receiving care in-network there is no paperwork to fill out — all you need to do is show your ID card to receive benefits. Your doctor will file your claims directly with the local Blue Cross and Blue Shield plan. For some out-of-network care, you may need to download a copy of our claim form.
Mail your completed claim form to the following address:
Blue Cross and Blue Shield of Illinois
P.O. Box 660603
Dallas, TX 75266-0603
Your BCBS member ID card will provide information about the BCBS network for AbbVie employees. Please present your ID card when obtaining services from doctors and hospitals so that he or she knows who to contact for eligibility, what medical benefits are available to you under the AbbVie BCBS Plan, and if pre-notification is required.
Contact BCBS Customer Service at 1-877-238-5951 to request a replacement ID card. To print a temporary ID card and obtain a replacement ID card, log in to Blue Access for Members.
To change your name or address, contact HR Central at 1-844-ONE-HR4U (1-844-663-4748). To add a dependent to your coverage, visit https://abbviebenefits.ehr.com or contact HR Central at 1-844-ONE-HR4U (1-844-663-4748). Newly acquired dependents must be added within 31 days of the qualifying event.