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2018 Blue Solutions Renewal Guide

Built-in benefits empower members to save on care All Blue Solutions plans give members the choice to save money — in some cases hundreds of dollars — based on where they go for care. Services members can save on: Preventive Plus — Preventive colonoscopy1 • Members pay $0 for a preventive colonoscopy by choosing Preventive Plus providers and GI professionals that are not hospital based2 • Out-of-pocket costs can be up to $750 by choosing non-Preventive Plus providers and professionals • Preventive Plus benefit included in all plans Outpatient lab services • Members pay their plan’s designated cost-sharing amount, which is higher, at a hospital-based lab • For HMO and Direct POS plans, in-network lab services are covered at 100 percent when members use their PCP’s designated lab site • All non-HSA and non-HRA plans offer $0 cost-sharing when members use a freestanding in-network lab Outpatient surgery • Members pay less at in-network ambulatory surgical centers (ASCs) • Common outpatient surgical procedures performed at ASCs include tonsil removal, hernia repairs, and cataract surgeries • Benefit included in most non-HSA-qualified plans Physical/occupational therapy and routine/complex radiology • Members pay less at office-based providers or freestanding sites • Member cost-sharing is higher at hospital-based sites • Benefit included in non-HSA-qualified PPO plans 1. Age and frequency guidelines apply to preventive care, such as colonoscopies. 2. The Preventive Plus benefit does not apply to members who reside or travel outside our service area and access care through the BlueCard® Program or the Away From Home Care® Guest Membership Program. For these members, a preventive colonoscopy to screen for colorectal cancer will be covered at no cost when they use an in-network provider. However, if they choose to visit an out-of-network provider, cost-sharing for their plan’s out-of-network benefit applies, and their out-of-pocket costs may be significantly higher. 2018 Blue Solutions | ibx.com/bluesolutions 6


2018 Blue Solutions Renewal Guide
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