Out-of-network Coverage

Coverage for care out of network will be covered, as follows:

• The deductible is doubled.
• The coinsurance increases by 20%.
• There is no limit to the calendar-year coinsurance maximum.
• Balance billing (the difference between the provider's bill and the Arkansas Blue Cross allowed amount) must be paid by the policyholder.

Optional Maternity Rider for Essential Blue Freedom

For Essential Blue Freedom members, an optional maternity rider is not available until after a 364-day waiting period.

Affordable Prescription Drug Benefits

Each of our individual health insurance plans uses a separate formulary (list of covered drugs). Comprehensive Blue PPO III and Essential Blue Freedom use the Value Formulary, which is a low-cost formulary alternative that emphasizes the use of generic drugs and includes select brand-name drugs in most categories of medications. HSA Blue PPO II uses Formulary Two, which is a more comprehensive formulary but it does NOT cover any drugs related to mental health. There is no prescription drug coverage if you use out-of-network pharmacies for any of these plans.

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Exclusions