Blue Advantage HMO^SM Product Overview

(51–150 employees) (151+ employees)

BlueAdvantage HMO members receive Primary Care Physician (PCP) coordinated care. See how members can work together with their doctor when making health care decisions:

Advantages

A PCP who:

• Knows and understands a member's healthcare needs
• Is informed about a member's medical history
• Provides basic medical care
• Prescribes medication
• Coordinates care and treatment with specialists and provides appropriate referrals

Additionally, members enjoy:

• Choice of a PCP from a large network of contracting HMO medical groups/independent practice associations
• No claim forms
• Flexible plan design options with deductible/coinsurance and copay features

Benefits

Members have access to a range of benefits with the BlueAdvantage HMO product.

• Doctor office visits
• Preventive care and wellness services for children and adults such as:
  
  • routine physicals
  • immunizations
  • tests and screenings for breast and cervical cancer, prostate and colon cancer

• Outpatient surgery and diagnostic tests
• Outpatient and inpatient hospital services and treatments
• Maternity care
• Behavioral health services (inpatient and outpatient)
• Rehabilitative therapy (such as physical, speech and occupational)

Other coverage and discounts on services such as:

• Emergency care
• Out-of-area coverage (traveling/temporarily living out of state)
• Vision exams at the cost of an office visit copay and discounts on lenses, frames and permanent contact lenses, vision correction surgery and disposable contact lenses
• Discounts on hearing aids
• Discounts on chiropractic care, acupuncture and massage therapy and health and wellness products

• Prescription drug card benefit with 90-day supply for maintenance medications

Network

BlueAdvantage HMO offers one of the largest provider networks of primary care physicians (PCPs) and hospitals in the state.

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