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BlueCard&reg Program

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Anthem members access care outside their Plan area as conveniently as they access their local Anthem network, with no additional paperwork or out-of-pocket expenses.  
Anthem gives members the power and strength of a national network of providers.  

helps save money by using providers that accept Blue Plan negotiated rates

offers convenience because there are no claim forms to file

easy to use since members are only responsible for their normal out-of-pocket expenses (copayment, coinsurance, deductible or noncovered services)

How It Works
The BlueCard® program gives Anthem members access to Anthem benefits all across the nation by uniting the Anthem Blue Cross and Blue Shield network with those of other Blue Cross and Blue Shield licensed companies. More than 80 percent of hospitals and nearly 90 percent of physicians in the U.S. contract with Blue Cross and Blue Shield Plans.1 The BlueCard Program links them all.  
Anthem members pay less out of their pockets when they receive care from Blue Plan physicians and hospitals because Anthem covers more at the in-network benefit level. 
Access Made Easy
To find a nearby health care provider, members can simply:  

go to anthem.com for direct access to the most current online Provider Directory.

call BlueCard Access at (800) 810-BLUE (2583).

call Anthem Member Services at the number on the back of their ID card.

Precertification: the Most Important Step
Precertification is when members get prior approval from Anthem for some types of care and services. Precertification activates the benefits and helps ensure that the covered services members receive take place in an appropriate setting, meet the medical necessity criteria of the health plan, and are paid appropriately.  

Members are responsible for getting precertification, even if the provider offers to precertify care or equipment.

We recommend that members call to verify the precertification.

If a member does not obtain precertification, he or she may be responsible for more out-of-pocket expenses, and certain services may not be covered.

Emergency Care
Precertification is not required for emergency treatment or admissions.  

Members must notify Anthem within 24 hours, or as soon as reasonably possible.

If members do not notify Anthem, charges may be denied for services determined to be medically unnecessary.

Claims Filed Locally
A “suitcase” icon on the ID card — either empty or containing the PPO product name — helps doctors and hospitals nationwide recognize a BlueCard member.  
To assist the member, the physician or hospital sends the claim electronically to the local Blue Cross and Blue Shield Plan, which sends the claim to Anthem. The claim is then processed by Anthem for reimbursement to the provider. 
 
 
Benefit Plan Differences
Members choose Anthem managed care benefit plans because working with a primary care physician (PCP) helps ensure the best coordinated care possible, at the lowest out-of-pocket cost. For that reason, there may be differences in the services covered, or in the level at which they are covered while traveling. 
Blue AccessSM

scheduled doctor appointments

preventive care benefits including: well baby and well child care, certain routine or periodic exams, immunizations

emergency and urgent care

Blue Traditional®: 

scheduled doctor appointments

emergency and urgent care

Blue Preferred® Primary, Blue Preferred® Primary Plus and Blue PrioritySM

emergency and urgent care

authorized follow-up care

©2005-2014 copyright of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Com pany. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use