BCBS Medical PPO

Print
Press Enter to show all options, press Tab go to next option

BlueCross BlueShield of Oklahoma (Medical)

Group Number: 019574

Customer Service Telephone: 1-877-219-4301

Customer Service Hours: Mon-Fri, 8 a.m. - 8 p.m. CST

Website: www.bcbsok.com/okc

  

Prime Therapeutics (Pharmacy)

Customer Service Telephone: 1-877-546-2779

Customer Service Hours: Mon-Fri, 8 a.m. - 6 p.m. CST

Website: www.myprime.com

The Group Indemnity Health Plan offers a broad network of doctors, allowing you the ability to select almost any doctor or hospital. By selecting a network doctor, lower coinsurance and deductibles are available. However, non-network care is still partially covered. Two options are available to retirees: Standard Plan and a higher deductible/co-insurance Alternative Plan.  Additional information can be found in the Retiree Guide to Benefits or Summary of Benefits and Coverage.

A prescription drug plan (New for 2018: administered by Prime Therapeutics) is offered with the Group Indemnity Plan. Prescription drugs must be included on the plan formulary to be covered.  Prime Therapeutics also provides a mail order prescription drug program thru Alliance Walgreens Prime Mail Order. Additional information can be found in the myPrime website.

What network of providers do I choose from?

To maximize your benefit and reduce out of pocket cost, select providers that are in the BluePreferred network.

What is a deductible?

A deductible is the portion of eligible medical expenses that the participant must pay before the plan will make any benefit payments.

What is coinsurance?

Coinsurance is a percentage that the patient is required to pay on all eligible medical expenses, after the deductible has been met.

What is the Out-of-Pocket Maximum?

An annual out-of-pocket maximum is the maximum amount of coinsurance and copayments you pay for eligible medical expenses in any single calendar year. Once you have paid the out-of-pocket maximum, the plan pays 100% of eligible expenses. 

Important Information for Medicare Participants

Once an individual becomes Medicare eligible under the Group Indemnity Plan, Medicare becomes the primary payer and BCBS becomes secondary.  The deductible, coinsurance, and out-of-pocket maximum still applies. 

Employee Benefits strongly encourages you to enroll in Medicare Part A and Part B. BCBS processes claims as a secondary payer to Medicare.  If you fail to enroll or maintain enrollment in Medicare Part A and/or Part B, you will become responsible for charges that Medicare would normally pay. 

The prescription plan offered under the Group Indemnity plan is not a Medicare Part D plan; however, the prescription plan is considered credible coverage in lieu of enrollment in a Medicare Part D plan.  You are not required to enroll in a separate Medicare Part D prescription plan while enrolled in the Group Indemnity Plan.

Blue Access MobileSM

Blue Access Mobile makes it easy for you to access your information while on the go. You can view coverage details, health and wellness information, check claim status and access ID card information. You can also sign up to get text or email alerts and tips for:

• Claims Information — Get alerts when a claim status changes.

• Exercise and Fitness — Get weekly tips to help improve your workouts.

• Prescription Drugs — Sign up for alerts to check blood sugar, take a medication or a multivitamin.

• Diabetes Diet — Get weekly diet management tips to help stabilize insulin levels.

• Heart Healthy Diet and Basic Care Management — Get weekly messages with heart healthy diet management and basic care tips.