©1996- Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. We provide health insurance in Michigan. Show State and Federal Privacy laws prohibit unauthorized access to Member's private information. Individuals attempting unauthorized access will be prosecuted. Important Legal and Privacy Information | Important Information About Medicare Plans | Privacy Practices Section hidden in CSS: https://www.bluecrossnc.com/admin/appearance/settings/bcbsnc
Behavioral Health Services
Blue Cross NC wants to make sure you have the most accurate and up-to-date information. But, because we often add new providers to our network, we can’t guarantee all the information in your search will be current. Call our customer service number on the back of your ID card to report information that is wrong. The Blue Cross and Blue Shield Association nor its licensees are liable for losses, damages, or charges as a result of using our provider search or from receiving provider care. You can refer to your Member Guide for information on if a service is covered on your plan. Quartet Health is an independent company providing behavioral health care support services on behalf of Blue Cross NC. Quartet Health does not offer Blue Cross or Blue Shield products or services. Additional Plan InformationDrug List OverviewBlue Cross and Blue Shield of North Carolina offers three drug formularies (drug lists) so Medicare beneficiaries can have options for their prescription needs. Blue Medicare HMO Enhanced, HMO Essential and Blue Medicare PPO Enhanced share the same Medicare prescription drug list. This list is based on a preferred list of FDA-approved prescription drugs and was developed using guidelines from the federal government. The drug list includes many highly utilized generic drugs and some brand name and specialty drugs. This list also includes a lower cost tier for some maintenance medications related to High Blood Pressure, High Cholesterol and Diabetic conditions. Blue Medicare Rx (PDP) Standard Plan prescription drug list is also based on a preferred list of FDA-approved prescription drugs and was developed using guidelines from the federal government. The drug list for this plan has many highly utilized generic drugs and some brand name and specialty drugs. Many of the most popular generic prescriptions are included. The Blue Medicare Rx (PDP) Enhanced prescription drug list is based on a preferred list of FDA-approved prescription drugs and was developed using guidelines from the federal government. The drug list includes more generic, brand name and specialty drugs. Generic drugs have the same active ingredient formulas as brand name drugs. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs. Certain vaccinations, insulin and insulin injection supplies are also covered on all formularies. Over-the-counter drugs are not covered because they are excluded by Medicare. To encourage the appropriate use of prescription drugs, some quantities are limited and some drugs must be approved before they will be covered. For more information, see prior authorization, step therapy, and quantity limitations. Like most insurance coverage, our Blue Medicare HMO, Blue Medicare PPO and Blue Medicare Rx plans have some limitations and exclusions. Recent Drug List ChangesThe drugs listed below have been removed from the specified formularies (drug lists). Please ask your doctor to prescribe a drug that is on the formulary to treat your condition. Your drug cost will depend on your specific prescription drug plan and the formulary alternative prescribed by your doctor. If you are affected by a change to the formulary, you will receive a written notice regarding the change at least 60 days before the change will take effect. Blue Medicare Rx Standard These drugs have been withdrawn or discontinued by the manufacturer:
The drug manufacturers have discontinued participation in the Coverage Gap Discount Program for these drugs:
Blue Medicare HMO/PPO and Blue Medicare Rx Enhanced These drugs have been withdrawn or discontinued by the manufacturer:
The drug manufacturers have discontinued participation in the Coverage Gap Discount Program for these drugs:
Questions about Drug CoverageIf you can't find your drug, your drug may not be covered. To verify whether a drug is covered, you may call Customer Service seven days a week from 8 am - 8 pm.
If your drug is not covered, you have the right as a member to request that an exception be made to the formulary or to request a transition supply while you find an appropriate alternative prescription. For instructions on how to request a transition supply or an exception to the formulary and instructions on how to appeal a decision about an exception or to file a grievance if you are dissatisfied for any reason, please review the following documents:
How do I find out what providers are on my network?How do you find an in-network provider?. Check your insurance company's website. Many insurance companies will post in-network providers for the plans they offer. ... . Check your provider's website. ... . Call your provider. ... . Call your insurance company. ... . Call your agent.. How do you ask a doctor if they are in network?Call the insurance company.
Let them know you want to check whether a provider is in-network, and give them both the specific plan name you are referencing and the doctor's tax ID number. They should be able to confirm whether or not the provider is in-network.
What does it mean when a doctor is in your network?When a doctor, hospital or other provider accepts your health insurance plan we say they're in network. We also call them participating providers. When you go to a doctor or provider who doesn't take your plan, we say they're out of network.
Is Florida Blue a PPO or HMO?Florida Blue HMO Plans
Our HMO plans offer over 7,000 in-network primary care providers (PCPs) and over 9,000 pharmacy locations to choose from! Not only is your PCP your main point of contact for your health care needs, but they will also provide you with referrals should you need to see an in-network specialist.
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Check if doctor is in network blue cross
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