BlueChoice (PPO)

Blue Open Access HMO/POS Brochure 

This preferred provider organization plan offers employers the potential for lower monthly health benefit costs, as well as lower out-of-pocket costs for employees, through an extensive state-wide network of physicians and hospitals, or non-network physicians at a reduced benefit.

Our BlueChoice PPO plan offers the choice of in- or out-of-network benefits. Members have the freedom to choose any health care provider. However, members receive greater benefits and lower costs when medical services are provided by a BlueChoice PPO network physician.

Our PPO plans provide two additional benefits for participating hospitals and physicians. The Prudent Buyer Program is a discount program with participating hospitals and the Participating Physician Program is an agreement with physicians to accept BCBSGA’s determination of “usual, customary and reasonable” (UCR) fees. These programs automatically apply to most out-of-network claims by providing the following added value benefits:

• Providers file claims to BCBSGA.
• 90% of Georgia’s providers accept our predetermined reimbursement as payment in full, minus member deductibles and coinsurance. There is no balance-billing for amounts above UCR.

• The American Accreditation HealthCare Commission/URAC – BlueChoice PPO has continued to receive full accreditation from the AAHCC/URAC since 1996
• Freedom of choice in plan selection for employers with choice of standard plans or customize benefits to fit employer needs
• Efficient and accurate claim processing reduces administrative workload
• No PCP referral requirement
• One of the largest PPO networks in the State of Georgia
• National Blue Cross and Blue Shield PPO access
• BlueChoice On-Call – 24-hour nurse information line

BCBSGa Plans

• BlueChoice Healthcare Plan (HMO)
• BlueChoice Option (POS)
• Blue Open Access HMO/POS
• BlueChoice PPO
• Blue Value Plan 3000 (MOST POPULAR PLAN!)
• PPO High Deductible (HSA-Qualified)
• Tonik
• Short Term or Temporary Health Insurance
• Small Business & Group Health Insurance
• Dental Plans