It's important to remember that many Blue Cross and Blue Shield Plans have specialty networks, such as clinical labs, physical therapists, infusion therapy networks and ambulatory surgical centers. If you are referred to a specialty care provider, ask in advance if they are a PPO participating provider in the local Blue Cross and Blue Shield Plan. The savings you will receive by using a participating provider will make it worth asking. Blue Cross and Blue Shield Plans are linked electronically. This allows the provider to quickly submit your claim electronically to your local plan for payment.
Covered dependents living outside the state are eligible for the same benefits.
However, reduced benefits may apply if no PPO network is available. Most Blue Cross and Blue Shield network providers agree to charge BlueCard PPO participants a special lower rate. Your share of the cost is also based on the special rate. These providers also agree not to bill the patient for the difference between the normal charge and the special rate. They accept the lower rate as payment in full.