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Effective
July 1, 2007 all Health
Plan participants are covered under a single network
On July 1, 2007, the medical and hospital network for Health Plan participants that reside outside of California switched from Private Healthcare Systems (PHCS) to the Blue Cross
BlueCard® network, a nationwide network of all local Blue Cross plans, including Blue Cross of California. This switch created one nationwide network for all Health Plan participants.
As part of the transition to
BlueCard®, the Health Plan issued new coverage cards to all Health Plan
participants in mid-June. If you did not receive your coverage card,
please contact the Health Plan.
To locate a
BlueCard® provider or to determine if your current provider is in the
BlueCard® network, click here.
Please refer to the current issue of Spotlight
on Benefits for more information.
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For Participants that reside in
California
Your network for medical and hospital providers in California has not changed. You will continue to be covered under the Blue Cross of California network. However, when you travel outside of California, you
are covered under the
BlueCardnetwork.
For Participants that reside
outside California
Your network for medical and hospital providers
is
BlueCard®, Blue Cross’ nationwide network of local Blue Cross plans. When you travel to California, you will be covered under Blue Cross of California.
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BlueCard® Q
& A
Will this change in networks result in changes to my benefits or coverage?
Will this change affect my prescription drug, dental and vision
coverage?
How can I find a list of BlueCard® providers in my area? How can I determine if my current provider is in the
BlueCard® network?
My current provider is not in the
BlueCard® network. What should I do?
Why did the Health Plan
issue new ID cards to all participants?
Can I use BlueCard®
providers for chemical dependency and mental health benefits?
Will this change in networks result in changes to my benefits or coverage?
No.
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Will this change affect my prescription drug, dental and vision
coverage?
No. Medco (prescription drugs), Delta Dental (dental benefits) and Vision Service Plans (vision benefits) will continue as the benefit managers of the Health Plan’s prescription drug, dental and vision benefits,
respectively.
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How can I find a list of BlueCard® providers in my area? How can I determine if my current provider is in the
BlueCard® network?
You can locate a BlueCard® provider
by clicking here.
In addition, you can call your provider’s office and ask if they participate in the BlueCard® network.
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My current provider is not in the
BlueCard® network. What should I do?
The Health Plan set up transition rules for participants and dependents
that were undergoing a current or immediate course of treatment prior to the
transition with a PHCS provider that is not in the BlueCard®
network. If you have any questions regarding the transition rules, you can contact the Health Plan office at (323) 866-2200, Ext. 401 or
(877) 866-2200, Ext. 401.
Unless you are eligible under the Plan’s transition rules, any services rendered by a
non-BlueCard® provider after June 30 will be covered at the lower non-network rate, even if the provider was previously in the PHCS
network.
If your provider is interested in joining BlueCard®, he or she can contact Blue Cross at
(800) 810-2583.
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Why did the Health Plan
issue new ID cards to all participants?
Since the change in networks allows all Health Plan participants to obtain services from a BlueCard®
provider (including California participants that travel outside California), new cards
were issued to all Health Plan
participants.
The new ID cards have a Health Plan-specific Participant ID number that will assist in standardizing claims processing. Your new Participant ID number will be your new identification number for Health Plan purposes, so you no longer have to print your Social Security number on your ID card, which will give you an additional layer of security against potential identity
theft.
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Can I use BlueCard®
providers for chemical dependency and mental health benefits?
PacifiCare remains the Plan’s benefit manager for chemical dependency and mental health benefits. Therefore, there is a separate network for those types of benefits. For more information, you can contact PacifiCare at
(888) 502-4502.
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