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UFCW LOCAL 1776 and
PARTICIPATING EMPLOYERS HEALTH and WELFARE FUND |
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Medical Coverage (Option B
only) |
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How the BlueCard PPO Program Works If you live or travel outside the Personal Choice Preferred Provider Network area and need medical care, follow these easy steps:  Call the BlueCard Access line at
1-800-810-BLUE
(2583) or visit the BlueCard Provider Finder website at
www.bcbs.com
to find a
participating Blue Cross/Blue Shield PPO physician or hospital in your location. This
toll-free number is
printed on the back of your identification card.
Go to the closest participating PPO physician or
hospital in your location and present your identification card. Call Independence Blue Cross at 1-800-332-2566
for
pre-certification/prior authorization when you live or travel outside the Personal Choice
Preferred Provider Network area.Important Pre-Certification Note: Certain services and treatments (such as inpatient admissions) require advance approval. When you use Personal Choice preferred providers, they take care of this for you. However, when you are outside the area served by the Personal Choice Preferred Provider Network, you will have to call and obtain these approvals yourself. Call the Member Services telephone number on the
back of your ID card for any other inquiries. As always, in an emergency seek immediate care
from the nearest health care provider."Out-of-Area" benefits If you live “out-of-area” with limited access to preferred providers (Personal Choice Network or BlueCard PPO Program) (that is, there are not at least 2 primary care physicians within 8 miles, 2 specialists within 15 miles, and 1 hospital within 15 miles of your home), you may use a non-preferred provider and your claims will be paid at the appropriate preferred benefit level. Payments under the Plan will be determined based on the Personal Choice covered expenses (as determined by Independence Blue Cross) rather than the pre-determined fee schedule for preferred providers since there is no agreement between Independence Blue Cross and the non-preferred provider. Also, because there is no agreement between the provider and IBC, the provider may bill you for the difference between the Personal Choice covered expenses and the provider’s actual charges. You will also be responsible for obtaining all required pre-certifications. Contact the Fund office to see if you qualify for out-of-area benefits. Healthy Lifestyles Program You are also eligible to participate in certain programs that may help you maintain your health. As an Blue Cross member, you can take advantage of a wide variety of innovative Healthy Lifestyles Programs. These programs provide you with incentives to help keep you and your family in the best of health. Your participation in any of these Healthy Lifestyles Programs will not affect your benefits under the Fund’s Physical Well Being Program. You will still be entitled to benefits under the Physical Well Being Program. You should refer to that section of the booklet for more details. Healthy Lifestyles Programs include: Health Management
- Weight Management with
Weight Watchers, Fitness Reimbursement, Health Management Programs, and
Smoking Cessation. Alternative Health
- Alternative Health
Discounts, Stress Management, and Better Sleep. Women’s Health
- Baby BluePrints Prenatal
Program, Mammography Birthday Card Program, and Pap Test Screening Program. Family Health
- American Red Cross Save-A-Life
Course Discounts, Adolescent Health, Pediatric Immunizations, Child Safety, and
Personal Health Profile.For a full description of the Healthy Lifestyles Programs, call the Health Resource Center at 1-800-ASK-BLUE( in Philadelphia, call 215-241-3367). |