Using physicians, hospitals, pharmacies and other health care professionals in our Preferred network helps to save you money on your health care expenses.
Standard Option
Under Standard Option, when you use Preferred providers, your out-of-pocket expenses, such as coinsurance and copayment amounts, are lower than if you use Non-preferred providers. You can also save if you use Member facilities and Participating physicians. All of these types of providers have agreements with local Blue Cross and Blue Shield Plans to accept 100 percent of our Plan allowance as payment in full. They will also submit claims for you and your family.
When you have Standard Option and use Non-member facilities or Non-participating physicians and other health care professionals, you out-of-pocket expenses will be greater. You are responsible for any amount applied to the calendar year deductible plus the appropriate coinsurance or copayment amount. In addition, you may be responsible for any difference between our payment and the amount billed by the provider.
Please refer to Section 5 in the 2010 Service Benefit Plan brochure (RI 71-005) for benefit information and to Section 10 in our brochure for information on how we determine our Plan allowance.
Basic Option
If you have Basic Option, you must use Preferred providers for your health care to be eligible for benefits, except in certain circumstances such as emergency care. You are normally responsible for any charges by Non-preferred physicians, facilities and other providers.
Locating Preferred Providers
It's easy. Just look in the online provider directory for a Preferred provider in your area. You can also call the local Blue Cross and Blue Shield Plan at the number on the back of your ID card.