Blue Advantage HMO^SM Product Overview

(51–150 employees) (151+ employees)

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

Advantages

Your PCP:

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

Additionally, you'll 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
• Mental health and substance abuse (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 copayment 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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