Blue Access for Employers

Blue Advantage Entrepreneur HMOSM

(2–50 employees)

Advantages

  • Members choose a contracting medical group/independent practice association from a large HMO network.
  • There is no annual deductible and generally no claim forms.
  • Copayment levels are low.

Benefits

Members also enjoy access to a range of benefits when care is provided/coordinated through their primary care provider (PCP).

  • Doctor office visits
  • Preventive care and wellness services for children and adults such as:
    • Routine physicals
    • Immunizations
    • Tests and screenings for breast and cervical cancer, prostate and colon cancer
  • Outpatient surgery and diagnostic tests
  • Outpatient and inpatient hospital services and treatments
  • Maternity care
  • Mental health and substance abuse (inpatient and outpatient)*
  • Rehabilitative therapy (physical, speech and occupational)

Other coverage that does not require a PCP referral includes:

  • Emergency care
  • Out-of-area coverage (traveling/temporarily living out of state)
  • Substance abuse treatment (inpatient and outpatient)
  • Vision exams, at the cost of an office visit copayment; discounts on lenses, frames and permanent contact lenses, vision correction surgery and disposable contact lenses
  • Discounts on hearing aids
  • Discounts on chiropractic care, acupuncture, massage therapy and health and wellness products
  • Prescription drug card benefit with 90-day supply program for maintenance medications

Network

Blue Advantage HMO is a broad provider network of contracting medical groups/independent practice associations and contracting hospitals at a more affordable cost.

Check with your representative to determine which package is the best fit for your company.

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*Members of Physicians Care Network, Inc. coordinates mental health care directly with the behavioral health network provider.

 

Related Information

Compare benefit plan designs


Contact your Blue Cross and Blue Shield representative for more information.