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The PPO Plan
BlueCross/BlueShield

As a member of the BC/BS PPO, you have great flexibility to choose your physician or other health care provider. Each time you need care, you may choose to receive services from a:

• PPO provider (in the Blue Network P)
• Non-PPO provider (outside of the Blue Network P)

The Blue Network P is a group of health care professionals that have agreed to special pricing arrangements for BC/BS plan participants. Blue Network P providers also agree to follow guidelines that, where medically appropriate, encourage the use of alternatives to costly hospitalization.

Physician Visits For office visits to physicians, your copay is $10 per visit — both in and out of the network. After your copayment, office visits are covered at 80% in-network and at 60% of approved charges outside the network.

Pharmacy Home Delivery:
You can have prescription drugs (up to a 102-day supply for most drugs) delivered to your home through your BCBS plan. For details, visit the Pharmacy section of the BCBS website at www.bcbst.com or call (800) 367-7790.

In-Network Benefits To receive maximum plan benefits, you should choose a provider who participates in the Blue Network P. Although in-network providers are listed in the directory published by the plan, it is important that you call the provider before you receive care and verify that he/she participates in the plan.

Out-of-Network Benefits If you receive care from an out-of-network provider (not a member of the Blue Network P), you will still receive benefits, but at a lower level.