![]() Trio+ Specialist visits for mental health services must be provided by a participating mental health service administrator (MHSA) network provider. This benefit is for a first specialist visit only subsequent visits will require a referral. Members should then select a specialist within that medical group or IPA. ** To use this option, members must select a PCP who is affiliated with a medical group or IPA that is a Trio+ provider group, which offers the Trio+ Specialist feature. Access+ HMO is a registered trademark of Blue Shield of California. Access+ Specialist visits for mental health services must be provided by a participating mental health service administrator (MHSA) network provider. * To use this option, members must select a PCP who is affiliated with a medical group or IPA that is an Access+ provider group, which offers the Access+ Specialist feature. Trio+ Specialists care office visit (self-referral)** Teladoc medical doctor or mental health professional video or phone consultation Please see your Evidence of Coverage and Disclosure (EOC&D) for a detailed description of coverage benefits and limitations. ![]() ![]() Medical benefit calendar-year out-of-pocket maximum Inpatient visits at a hospital or skilled nursing facility Hearing aid - up to a maximum of $1,000 per member, every 36 months for both ears for the hearing aid instrument and ancillary equipment Other specialist care office visit (referred by PCP)Įmergency care - no copayment if hospitalized or kept for observationĮye refraction to determine need for corrective lensesĮyeglasses - not covered, except for those that are necessary after cataract surgery Teladoc medical doctor or phone consultationĪccess+ Specialists care office visit (self-referral)* Steps previously taken by BCBS companies include: covering full costs of medically necessary diagnostic tests related to COVID-19, waiving of prior authorizations for diagnostic tests and covered services for members if diagnosed with COVID-19, increased access to prescription medications, and expanded access to telehealth and nurse/provider hotlines.įor more information, please visit or the CDC coronavirus homepage.Pregnancy and maternity care: prenatal/postnatal office visits This builds on the commitment we previously announced to ensure swift and smooth access to care during the COVID-19 outbreak.” We are also advocating for physician and health system adoption of social distancing-encouraged capabilities such as video, chat and/or e-visits. The expanded coverage includes waiving cost-sharing for telehealth services for fully-insured members and applies to in network telehealth providers who are providing appropriate medical services. Today, Blue Cross and Blue Shield (BCBS) companies announced a new policy regarding telehealth services that ensures members have swift access to the care needed to get and stay healthy – at no cost to them.Īll 36 independently-operated BCBS companies and the Blue Cross and Blue Shield Federal Employee Program® (FEP®) are expanding coverage for telehealth services for the next 90 days. “The safety and security of our members – and of all Americans – remains our paramount priority during these unprecedented times. Please check with each local Blue Cross and Blue Shield (BCBS) company for a full understanding of breadth of services since coverage may vary. As a partner in joint operating agreements, Highmark Blue Shield also provides services in conjunction with a separate health plan in southeastern Pennsylvania.
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