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 co-pays: 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.
Here are just some of the services covered under this plan:
*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.
For a complete list of covered services and to learn about coverage decisions, see the Member Handbook.
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
Coverage Decisions
Blue Cross Community Health Plans has strict rules about how decisions are made about your care. Our doctors and staff make decisions about your care based only on need and benefits. There are no rewards to deny or promote care. Blue Cross Community Health Plans does not encourage doctors to give less care than you need. Doctors are not paid to deny care.
If you want to know more about the utilization management process or how decisions are made about your care, contact Member Services at 1-877-860-2837 (TTY/TDD: 711).