Medical Benefits

As a Blue Cross Community Health Plans member, you have access to medical, dental, vision, behavioral health, prescription drug coverage and more. Some special benefits include:

Zero copays: You pay nothing ($0) when you go to a doctor or health care provider in the plan's network.
24/7 Nurseline: If you have questions, our nurses have answers. This help line is staffed all day, every day with registered nurses. If you have an unexpected medical situation, call the Nurseline at 1-888-343-2697. A nurse can help you decide if you should call your doctor, visit the ER or urgent care, or treat the problem at home.
Blue365^®: Save money on health and wellness products and services through this online discount program. Sign up for email alerts to see new offers.

What Is Covered?

The table below contains some of the services covered under your BCCHP plan. Some of these services may require a prior authorization (getting an OK from BCCHP). To learn more about prior authorizations, visit the prior authorization page.

For a more in-depth list of covered services and services that require prior authorizations, see page 3 of the Certificate of Coverage.

TYPE OF CARE	COPAY	BENEFIT LIMIT/EXCLUSIONS	REQUIRES PRIOR AUTHORIZATION?*
Annual Adult Well Exams	$0	Well exam must be done by your Primary Care Provider (PCP) or Women’s Health Care Provider (WHCP)	No
Behavioral Health Services	$0	Some services include: Alcohol or drug treatments Care during a hospital stay Outpatient behavioral health services Mobile Crisis Response services	Yes, under certain circumstances.
Chiropractic Services	$0	Limited to spinal manipulation for subluxation of the spine.	No
Dental Services^†	$0	Services include: Routine Exams Cleanings Fillings Root canals Dentures Extractions	Yes, under certain circumstances, a Prior Authorization is required for non-covered benefits.
Emergency and Urgent Care Services	$0		No
Family Planning Services and Supplies	$0	Services include: Doctor visit Birth Control Family Planning and Education Services that are not included: Fertility treatments Surgery to reverse sterilization	No
Home Health Care Services	$0	Services include: Home health aide services Speech therapy Physical therapy visits	Yes
Hospital Emergency Room Visits	$0	Go to the nearest hospital in an emergency.	No
Hospital Inpatient Services and Ambulatory Services	$0		Yes
Laboratory and X-ray Services	$0	Services include: All medically necessary lab services Cancer tests X-ray services	Yes, these services must be ordered by your PCP.
Non-emergency Transportation Services	$0	Services include transportation to: A doctor's appointment An appointment with another health care provider BCCHP sponsored events	You are not required to obtain a prior authorization for standard non-emergency transportation services.
Vision Services	$0	Services include: One (1) eye exam every 12 months per member Eye glasses: Every two (2) years for member age 21 and older Replaced "as needed" for members under 21 Additional reimbursement toward a pair of upgraded eyeglass frames Contact lenses when medically necessary	Yes

^*Services must be medically necessary. Some services need approval from your health plan before you get treated. This approval is called "prior authorization." Your doctor should know which services need approval and can help with the details.

^†Some limits apply to general dentistry.

What Is Not Covered?

Some services that are not covered include:

Cosmetic surgery or treatment that are not medically necessary
Procedures that are still being tested or experimental
Services by non-licensed providers
Drugs and supplies without a prescription
Acupuncture
Services in an emergency room for health issues that are not emergencies

Find a Provider

Use our Provider Finder^® to search for doctors and other providers.

Member Resources

See the BCCHP Blue Kit^SM or MLTSS Blue Kit^SM for details on benefits and services.

Need Help?

1-877-860-2837
(TTY/TDD: 711)
The call is free.