| BluePreferred
PPO for Individuals Plan: Comprehensive
Benefits and Convenience at Surprisingly
Competitive Rates |
This preferred provider organization
(PPO) health plan offers comprehensive
benefits, competitive rates, plus referral-free
access to one of the largest provider networks
in the state.
Network or Non-network:
The Choice is Yours. Whether you choose
a health care professional from our extensive
preferred provider network,
or choose to visit a non-network provider, BluePreferred
PPO for Individuals helps keep your costs manageable.
BluePreferred offers coverage for most care
received from non-network providers, however,
to receive the highest level of benefits, we
recommend you choose a provider who participates
in the BluePreferred PPO network.
Comprehensive, Referral-free Care. BluePreferred offers
referral-free care from a preferred provider
network
of nearly 3,700 healthcare professionals and
19 hospitals throughout Nevada - and the freedom
to choose a non-network provider at a higher
out-of-pocket cost.
When You Need Surgery, Non-emergency Hospital Care and Certain Procedures
or Services. If your doctor determines you should be hospitalized, require
surgery, certain procedures, services or drugs, BluePreferred requires
preauthorization. When you use network providers, they will take care of
preauthorization for you. If you use non-network providers, ensuring your
doctor gets preauthorization is your responsibility.
Urgent/After-hours Care. Urgent and after-hours care are covered by
BluePreferred. Choosing an urgent care facility when appropriate, instead of
an emergency room, usually reduces out-of-pocket expenses.
BlueCard® Program.
The BlueCard® program provides health care access
across the U.S. when you are traveling and your
condition requires attention before you will
return home. Contact 1-800-810-BLUE or visit
the BlueCard® Doctor and Hospital
Finder
Worldwide Emergency Care. BluePreferred covers you anytime, anywhere,
for emergency care. Simply call 9-1-1 or go immediately to the nearest
emergency facility.
Benefits: BluePreferred PPO for Individuals Plan
BluePreferred provides the benefits you care most about and then some. Here is
a snapshot of the coverage offered by BluePreferred:
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Inpatient and outpatient surgery, and hospital
benefits including covered drugs, lab services and x-rays,
anesthesia, oxygen and blood transfusions received during approved
hospital stays. |
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Preventive care. Many preventive care
services are covered, including well-child physician office visits,
immunizations for children, and health screenings such as mammograms,
Pap tests and prostate cancer screenings. |
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Physician office visits (when you have an
illness or injury). For most plan designs, non-routine office visits
to network doctors are covered at 100% after a copay. |
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Vision benefits, including comprehensive eye
exams, eyeglasses and contact lenses obtained
directly from vision providers in our
Provider
Directory. If you choose to receive
care from a non-network provider, benefits
will be paid at a lower, non-network level,
and you will be required to file a claim
for reimbursement. |
|
Prescription
drugs from nearly every independent
or chain store pharmacy in the state,
plus economical mail-order drugs, where
available. Locate a pharmacy near you
in the Provider
Directory. |
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Many family planning services including oral and
injectable contraceptives, contraceptive devices and sterilization. |
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Mental health diagnosis and treatment for select
inpatient and outpatient services. |
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Other “extras.” BluePreferred provides
benefits for things you might not expect, including physical,
occupational and speech therapy, dental care for accidental injuries,
home health and hospice care, as well as second surgical opinions. |
Some benefits and services are subject to an annual deductible, maximum
benefit, and/or coinsurance.
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