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 Plus uses the HMO Plus 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 doctors and hospitals are in-network with your HMO Plus plan. You can use BlueCard providers, but at a higher out-of-pocket cost for care.
You do NOT have coverage for care outside of the HMO Plus and BlueCard networks—except in emergency situations or with prior approval from Blue Cross of Northeastern Pennsylvania. In these situations, you will be charged the low, in-network cost for your care.
If you use doctors or hospitals out of the HMO Plus network, you will have to pay the full cost of your care out of your own pocket.
Get more information: