Blue Cross - PPO Preferred Provider Plan

Blue Cross - PPO Preferred Provider Plan



The PPO Program is an indemnity health insurance plan that utilizes most of the major hospitals, pharmacies, and many doctors as Preferred Provider Organizations (PPO). This plan provides 90% coverage, after deductibles, when the plan member uses a PPO provider. If a plan member uses a non-provider when a PPO provider is available, the coverage is 70% after deductibles. If there is no PPO provider available the coverage is 80% after deductibles. There is a $500.00 deductible per family member with a maximum of $1500.00. Blue Cross/Blue Shield uses a utilization review company to review all hospitalizations and some outpatient surgeries. Failure to notify the utilization review company will result in a penalty incurred against the plan member (maximum penalty to $2000.00). A list of PPO providers is available from the Human Resources Office. Coverage for non PPO services for plan members who reside out of state willbe 90%(subject to plan year dedcutible and/or co-insurance. Member pays difference between billed amount and fee schedules).

For current rates, click here to go to the rate table.

For more information please call 1-800-272-8451.

Visit their website at www.groupbenefits.org


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