Blue Preferred PPO Plan:
Blue
Cross And Blue Shield
Comprehensive benefits with freedom of choice—at a slightly
higher cost. This health plan gives you referral-free access
to one of the largest preferred provider networks in Nevada.
And, because Blue Preferred PPO also offers out-of-network
benefits, this plan empowers you to make decisions about your
doctor, your care and your costs when and where you need
treatment.
In-network or Out-of-network: The Choice is
Yours. When you
visit one of the more than 5,000 health care professionals and
hospitals in our provider network, you’ll receive the highest
level of benefits. In fact, most plan designs have no annual
deductible when you visit in-network providers. If you choose
to visit an out-of-network provider, Blue Preferred PPO
provides benefits to help keep your costs manageable.
Comprehensive, Referral-free Care. Blue Preferred PPO offers
all the basic health plan benefits—routine care, urgent and
emergency care, and coverage for hospital treatment and
surgery—and the freedom to choose an out-of-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, or that you require surgery, certain
procedures, services or drugs, Blue Preferred PPO requires
preauthorization. When you use in-network providers, they will
obtain preauthorization for you. If you use non-network
providers, ensuring your doctor obtains preauthorization is
your responsibility. Ask your doctor to call the number on the
back of your health plan ID card to initiate the
preauthorization process.
Surgical procedures, radiology tests, and occupational, speech
and physical therapy visits are some of the types of services
that require preauthorization. Please see our Referrals and
Preauthorization FAQ for additional details.
Worldwide Emergency Care. Blue Preferred PPO
covers you
anytime, anywhere, for emergency care. Simply call 911 or go
immediately to the nearest emergency facility. You will be
responsible for your emergency room copayment and/or
coinsurance. Your copayment will be waived if you are admitted
to the facility.
Urgent Care. Benefits are provided for
visits to urgent care
centers, clinics or other facilities for non-emergency,
after-hours medical conditions. Urgent care is a convenient
alternative when your physician’s office is closed and you
need prompt medical attention. Choosing an urgent care
facility when appropriate, instead of an emergency room,
usually reduces your out-of-pocket expenses.
BlueCard® Program. The Blue Card program
provides health care
access across the U.S. when you are traveling and your
condition requires attention before you return home. Call
800-810-BLUE toll free.
Benefits: Blue Preferred PPO Plan
Following is a partial listing of the plan benefits:
Physician office services and consultations
Preventive care services, including gynecological exams
and mammograms, prostate cancer screenings, and
well-baby/well-child care and immunizations for children
Maternity and newborn care, including diagnosis, care
during pregnancy and delivery services
Prescription drugs from a large network of independent
and chain-store pharmacies in the state, plus economical
mail-order drugs, where available
Hospital treatment and inpatient/outpatient surgery
Laboratory and X-ray services
Many family planning services, including oral and
injectable contraceptives, contraceptive devices, and
sterilization
Urgent and emergency care and ambulance services
Physical, occupational and speech therapies
Behavioral/mental health care with alcohol/chemical
dependency rehabilitation treatment services
Home health aide, nursing and therapy services, and
hospice care.
Some benefits and services are subject to an annual
deductible, maximum benefit and/or coinsurance.
This plan overview is intended to be a brief outline of
coverage. All terms and conditions of coverage, including
benefits and exclusions, are contained in the certificate and
Summary of Benefits, which shall control in the event of a
conflict with this overview.
Features: Blue Preferred PPO Plan
In addition to basic health plan benefits such as preventive
care, urgent and emergency care, and coverage for hospital
treatment and surgery, Blue Preferred PPO offers Anthem Healthy
SolutionsSM to educate and guide you toward better health.
Disease management programs are offered for asthma,
diabetes, coronary artery disease, congestive heart
failure and end-stage kidney disease. Blue Preferred PPO
also offers a high-risk maternity program for those
mothers needing extra guidance. Participation is
voluntary and confidential. Call 877-236-7486 toll free
for more information.
Anthem is
proud to carry on the tradition of bringing you the health
plans you prefer from a company you can count on.
As the only licensed Blue Cross and Blue Shield health care
benefits insurer in Nevada, Anthem Blue Cross and Blue Shield
offers the strength and security that comes with being one of
the largest, most-experienced health insurance organizations
in the nation. Nearly one in three Americans enjoys the
benefits of coverage from Blue Cross and Blue Shield plans.
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Important:
This plan overview is intended to be a brief outline of
coverage. All terms and conditions of coverage, including
benefits and exclusions, are contained in the Certificate,
which shall control in the event of a conflict with this
overview.
These programs may be terminated or modified at the discretion
of Anthem Blue Cross and Blue Shield's
The brief description of the plans provided through Anthem Blue Cross and Blue Shield are a general guide for more detailed description please contact Denise Brown about coverage, benefits, limitations, exclusions and any additional information about cost and enrollment.
Forging a New Path to Better Health Care,
Denise Brown Owner/Broker
Direct Health & Life of Nevada
Independent Authorized Nevada Agent
Phone: (702) 349-7579
email: dee2000@cox.net