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$5,000,000 in lifetime benefits per covered member.
Given the high cost of health care, it’s reassuring to
know that each covered member has that much protection.
Wellness benefits. You’ll have benefits that help to keep you healthy,
including coverage for routine physical exams,
gynecological exams and more — all with no
deductible to meet.
Benefits for children’s preventive services.
Children’s well-patient care (office visits only) and immunizations are covered at 100 percent.
Access to our extensive network.
You can lower your out-of-pocket costs by choosing a
provider from our extensive network for your medical
care. Chances are, your doctor or specialist already
participates. What’s more, you can see any
participating specialist without a referral.
Out-of-network coverage: You have the choice to
seek care outside the network and still be covered,
although you’ll be responsible for more of the costs.
For out-of-network care:
- Your out-of-network deductible is doubled. (For
instance, if your in-network deductible is $2,500,
your out-of-network deductible will be $5,000.)
- Applicable coinsurance is doubled once the
deductible is satisfied. There is no limit to your
calendar-year coinsurance maximum amount if
using out-of-network providers because
out-of-network expenses do not satisfy any
portion of the in-network deductible or calendar-year
coinsurance maximum.
- If you go out of network, you will be responsible
for any “balance billing” — in other words, the
difference between the provider’s bill and the
Arkansas Blue Cross allowed amount.
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Affordable Prescription Drug Benefits.
Prescription drug benefits can help to dramatically
lower your out-of-pocket costs. Prescription drug
benefits are based on a formulary (a list of covered
drugs). Comprehensive Blue PPO uses Formulary One (2068 KB PDF):
- $10 copayment for generic prescription drugs;
- $35 copayment for brand-name drugs; and
- $70 copayment for non-preferred brand-name drugs.
HealthConnect Blue
With HealthConnect Blue, better health is just a call
or click away. Personal health coaches are available
24/7 to advise you on everything from common health
concerns to chronic conditions. You’ll receive the
latest information on health education programs,
covering topics such as cardiovascular health, diabetes,
weight loss and more. Plus, you’ll have access to
online tools and information to help you make decisions
about your health.
Add Optional Maternity and Obstetrical Care Benefits Comprehensive Blue PPO plans provides the option of adding a maternity and obstetrical care
rider — with no per pregnancy maximum. Benefits are payable once the maternity
coverage has been in effect for 12 months. This optional benefit is available
only to females age 18 or older. Dependents other than a covered spouse cannot
purchase the maternity rider. The maternity rider covers the mother only.
Maternity benefits are subject to the deductible and coinsurance. Coinsurance
will not apply toward the annual out-of-pocket coinsurance maximum.
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