- The largest HMO network of doctors and hospitals
- The lowest out-of-pocket costs for care from in-network doctors and hospitals
- Coverage for urgent and follow-up care when out of the area from national and worldwide BlueCard® providers—at the same cost for care as if you were home, with prior approval
- Select a PCP to help manage your care, and ensure you’re getting the most from your coverage
- No referrals, no claims and low copays when you see in-network specialists
- No out-of-pocket costs for preventive care
- Exclusive wellness discounts on fitness classes, nutrition counseling, massages, restaurants and more
- Access to your own personal health coach and 24/7 access to registered nurses—so you’ll have the support you need to stay healthy, anytime
Below are links to resources to help you understand your health insurance plan. Be sure to bookmark this page and refer to it often. More information is also available on Self-Service—logon today.
| Member Handbook Kit✝|
Your Member Handbook kit makes your health insurance plan easier to understand and use. It explains what’s covered and how to get care. | Learn More
| Rx Drug Benefits|
If your employer offers prescription drug coverage through BCNEPA, your plan may have either the multi-tiered or coinsurance program. These programs help keep your drugs affordable because they use a
formulary. | Learn More
Need more information? Click on the links on the left. You can also email Customer Service through Self-Service or give us a call at 1.800.822.8753 or (TTY) 1.800.413.1112, weekdays, between 8 a.m. and 5 p.m.
*If your plan is self-insured, be sure to read this version of Your Blue Book to see how Blue Cross of Northeastern Pennsylvania works with your plan sponsor for the best coverage and benefits. Check with your employer or plan administrator to see if you have a self-insured plan.
✝Policies and provisions described in the documents referenced here may not apply to all self-insured group plans.
BlueCare HMO uses the HMO network. Using in-network doctors and hospitals for all covered medical care and services will always save you money, because your costs for care are the lowest in-network.
BlueCard network doctors and hospitals are out of your HMO plan’s network. BlueCard providers can be used ONLY for urgent care and follow-up care. You will pay the low in-network cost for urgent and follow-up care ONLY with prior approval from Blue Cross of Northeastern Pennsylvania.
You do not have coverage for care out of the HMO network, except in emergency situations. In emergency situations, you will be charged for your care as if you were in network.
If you use providers out of the HMO network, without prior approval from Blue Cross of Northeastern Pennsylvania, you will have to pay the full cost of your care.
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