Get Started Now

Use these steps and make the most of your health care coverage.
Be Prepared

Log in to your health plan online and learn how it works.

Use Helpful Information

Stay informed and use these tools for cost-effective options.

Take Us With You

Wherever you are, get the care that works for you.

Know Your Health Plan

Here are some key basics to know about your health plan. Remember, when you see a doctor outside of your plan’s network, you’ll pay more or all of your bill.
  • HMO
    Health Maintenance Organization
  • PPO
    Participating Provider Option
HMO
Health Maintenance Organization

Primary Care Provider (PCP)

You’ll need to select a PCP for your care. This is the one doctor who arranges your care and refers you to specialists.

Prior Authorization

Some services may require prior authorization (pre-approval).Ask your doctor about this so you’re sure who handles this step.

Plan Network

You’ll need to see a health care provider in your plan’s network. If you don’t, you’ll pay for most of or the full cost of your care.

See cost examples

Preventive Care Services

Some screenings, like your Annual Exam, are included with your health plan at no additional cost.

PPO
Participating Provider Option

Primary Care Provider (PCP)

You don’t need to select a PCP for your care, but it’s recommended. A PCP can coordinate your care and refer you to specialists.

Prior Authorization

You don’t need referrals to see specialists, but you may need prior authorization (pre-approval).1 Always talk with your doctor about your care.

Plan Network

You can see any health care provider in your plan’s network. But, if you get care from an out-of-network doctor, you may spend more.

See cost examples

Preventive Care Services

Check your Plan Benefit Book to see the screenings and services you can get at no additional cost to you, like your Annual Exam.

Get the Right Care

Let your symptoms guide where you choose to go for care. We call these choices SmartER CareSM options.

Your Doctor
Get regular care

The person you work with and see for regular checkups or sickness. Examples: Fever, colds and flu

24/7 Nurseline
Ask questions

A toll-free number to call for general health-related questions and advice on care options.2 Examples: Headaches, dizziness or sick child problems

Virtual Visits
Request a virtual doctor visit on your device

A live, non-emergency medical or behavioral health doctor visit by phone, online video or mobile app.3 Examples: Allergies, depression or pink eye

Retail Clinic
Get care if your doctor isn’t available

A place to get non-emergency care if your doctor isn’t available.4 Examples: Minor injuries, pain or sore throat

Urgent Care
Get immediate, non-emergency care

A place to get urgent medical attention when it’s not an emergency. Examples: Cuts that need stitches, sprains or animal bites

Emergency Room (ER)
Get emergency care

A place to get emergency care. Examples: Heart attack, heavy bleeding or broken bones

Protect Yourself with Prevention

Know about today’s care needs and work on managing longer-term health issues.

Preventive Care Screenings

Get your up-to-date health information with screens for:

  • Diabetes
  • Cholesterol
  • Heart disease
  • Body Mass Index (BMI)

Some, like your Annual Exam, are offered at no cost to you.

View Annual Exam video

Preventive Care Services

Other preventive care services with no out-of-pocket costs are:

  • Immunizations and vaccines
  • Losing weight
  • Ways to stop smoking
  • Maternity and well-child visits

Remember to talk with your doctor about your lifestyle and any life changes.

Learn more about preventive care services

Care for Your Emotional Well-Being

Help is nearby for both your physical and mental health.

Seeking Emotional Care

Check your Plan Benefit Book to see covered mental health services with your health plan.

Finding Helpful Providers

There are many kinds of experts you can see or talk with who offer mental health care.

Understand Your Pharmacy Benefit

Knowing how your pharmacy benefits work can help lower your prescription drug costs.
  • See Covered Drugs
  • Ways to Save
  • Other Pharmacy Tips
See Covered Drugs
Find out if your prescription drug is covered to prevent any surprises at the pharmacy.

Check to see if your drug is on the 2020 Drug List.

Consider Generic Drugs

Ask your doctor about generic drugs.

Learn more about saving with generics

Ways to Save
Just like with health care coverage, your pharmacy costs may depend on where you fill your prescriptions.

Generally, you’ll pay lower copay or coinsurance costs if you go to an in-network pharmacy.

Find an in-network pharmacy

When you visit a Preferred Pharmacy Network (PPN), you’ll get the lowest copay or coinsurance amounts.

Learn more about your PPN

Other Pharmacy Tips
Always talk to your doctor or pharmacist about any questions or concerns.

For some drugs, you may need to meet certain criteria before coverage can be approved.

Learn more about prior authorization or step therapy programs

Review your prescription plan materials.

Check out other pharmacy benefit information

Enjoy Extra Member Discounts

With Blue365®, you can save on health care products and services.5 Some of these may not be covered by your health plan.

More Resources and Contacts

1 Prior Authorization not required in certain circumstances, such as emergency or urgent situations. 

2 The 24/7 Bilingual Nurseline may not be available with all plans. Check your benefits booklet for details.

3 Internet/Wi-Fi connection is needed for computer access. Data charges may apply. Check your cellular data or internet service provider’s plan for details. Non-emergency medical service in Idaho, Montana and New Mexico is limited to interactive audio/video (video only), along with the ability to prescribe. Non-emergency medical service in Arkansas is limited to interactive audio/video (video only) for initial consultation, along with the ability to prescribe. Behavioral Health service is limited to interactive audio/video (video only), along with the ability to prescribe in all states. Service availability depends on location at the time of consultation.

Virtual Visits, Powered by MDLIVE may not be available on all plans. Virtual Visits are subject to the terms and conditions of your benefit plan, including benefits, limitations, and exclusions. MDLIVE operates subject to state regulations and may not be available in certain states. MDLIVE is not an insurance product nor a prescription fulfillment warehouse. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA-controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. MDLIVE physicians reserve the right to deny care for potential misuse of services.

MDLIVE operates and administers the virtual visit program and is solely responsible for its operations and that of its contracted providers. MDLIVE and the MDLIVE logo are registered trademarks of MDLIVE, Inc. and may not be used without written permission.

Blue Cross®, Blue Shield® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.

4 Visiting a Retail Clinic may not be covered with all plans. Check your benefits booklet for details. 

5 Blue365 is only available to Blue Cross and Blue Shield of Illinois (BCBSIL) members with active health plan coverage. Members who do not have an active health plan with BCBSIL will not be able to register on the Blue365 website.

The relationship between Blue365, its vendors and BCBSIL is that of independent contractors. Blue365 is a discount program available to BCBSIL members who have medical coverage with BCBSIL. This is NOT insurance. Some of the services offered through Blue365 may be covered under your health plan. Please refer to your benefit booklet or call the customer service number on the back of your ID card for specific benefit information under your health plan. Use of Blue365 does not affect your premium nor do costs of Blue365 services or products count toward your plan deductible, calendar year or lifetime maximums. Discounts are only available through participating vendors.

BCBSIL does not guarantee or make any claims or recommendations regarding the services or products offered by Blue365 and its vendors. You may want to consult with your physician prior to use of these services and products. Services and products are subject to availability by location. BCBSIL reserves the right to discontinue or change this discount program at any time without notice.