What is BlueCard PPO EPO?

Asked by: Dessie Towne MD  |  Last update: February 11, 2022
Score: 4.7/5 (12 votes)

The EPO (Exclusive Provider Organization) plan delivers in-network-only benefits through the national BlueCard® PPO network. EPO members must seek care from participating BlueCard PPO providers, except in the case of a life- or limb-threatening emergency. ...

What is the difference between Blue Cross PPO and EPO?

An EPO or exclusive provider organization restricts members to specific providers, facilities, and other medical services. ... In comparison, a PPO offers coverage for both in-network and out-of-network providers and facilities. However, Members will pay a higher out-of-pocket cost for using providers outside the network.

What is a BlueCard PPO?

The BlueCard PPO program is the premier national Blue Cross and/or Blue Shield Preferred Provider Program that links together more than 600,000 network doctors and 6,000 network hospitals in 48 states. ... Members can access any network doctor or hospital at any time and enjoy the in-network level of benefits.

What type of insurance is blue card?

What is the Blue Card program? The Blue Card program is offered by the nationwide Association of Blue Cross Blue Shield. It does not apply to HMO networks or plans. The Blue Card program essentially extends a members network to Blue Cross Blue Shield providers in other States for PPO plans.

How do I use BlueCard?

EU Blue Card Eligibility Criteria
  1. Have a Master's Degree or equivalent.
  2. Have at least 5 years of experience in your field.
  3. Have a work contract or a job offer for highly qualified employment for at least one year.
  4. Meet the minimum salary threshold in the EU country in which you want to work.

What is an HMO, PPO, HDHP or EPO

40 related questions found

Do I have BlueCard?

BlueCard claim? A Go to blueshieldca.com, log on to I'm a Member, and then select the Claims tab to check the status of your claim. ... If you have other questions about the BlueCard Program, please refer to your EOC or COI booklet, or call the Blue Shield Customer Service number on your member ID card.

How do I know if I have BlueCard PPO?

A blank suitcase logo on a member's ID card means that the patient has Blue Cross Blue Shield traditional, POS, or HMO benefits delivered through the BlueCard Program. You'll immediately recognize BlueCard PPO members by the special “PPO in a suitcase” logo on their membership card.

What is BlueCard traditional?

What is the BlueCard® Traditional Program? A national program that offers members traveling or living outside of their Blue Plan's area the traditional/indemnity level of benefits when they obtain services from a physician or hospital outside of their Blue Plan's service area.

Whats better PPO or HMO?

HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan.

Is an EPO a PPO?

A PPO (or “preferred provider organization”) is a health plan with a “preferred” network of providers in your area. ... An EPO (or “exclusive provider organization”) is a bit like a hybrid of an HMO and a PPO. EPOs generally offer a little more flexibility than an HMO and are generally a bit less pricey than a PPO.

How does an EPO plan work?

Exclusive Provider Organization (EPO) health plans offer a local network of providers and hospitals from which members can choose to receive care. EPOs generally have lower monthly premiums than PPO plans but members cannot receive covered care outside of their plan's work with the exception of an emergency.

Why is EPO more expensive than PPO?

Exclusive Provider Organization. Has a network of healthcare providers that it works with exclusively. ... EPOs are usually cheaper than PPOs due to the restrictions on which healthcare providers you can visit. See also Coinsurance vs Copay.

Is HMO or EPO better?

EPO health insurance often has lower premiums than HMOs. However, HMOs have a bigger network of healthcare providers which more than makes up for it. You may also want to consider your location when choosing a health insurance plan. EPOs are better suited for rural areas than HMOs.

What EPO means?

A managed care plan where services are covered only if you go to doctors, specialists, or hospitals in the plan's network (except in an emergency).

Can I have both HMO and PPO?

Yes, you can have two health insurance plans. Having two health insurance plans is perfectly legal, and many people have multiple health insurance policies under certain circumstances.

What are BlueCard claims?

The BlueCard Program allows health care providers to submit claims for members from other BCBS Plans, including international BCBS Plans, directly to BCBSMT.

What are blue card Fees?

BlueCard Fees means the fees assessed under the national program established by BCBSA under which BCBS Plan Enrollee claims are processed by BCBS Plans when an Enrollee receives health care services outside of the area served by their BCBS Plan.

What does the blue card cover?

The BlueCard Program* helps Blue Cross and Blue Shield of Texas (BCBSTX) members: Get needed health care when you travel or live outside your Blue Plan service area. Get the same benefits as your BCBSTX plan when you travel or are away from home for an extended amount of time.

Is blue card the same as Blue Shield?

The BlueCard Program eliminates the need for you to deal with multiple Blue Cross and/or Blue Shield Plans. Blue Shield of California is your single point of contact for BlueCard claims, payments, adjustments, service and claims-related inquiries.

What is PPO good for?

A PPO is generally a good option if you want more control over your choices and don't mind paying more for that ability. It would be especially helpful if you travel a lot, since you would not need to see a primary care physician.

What is Blue Shield National?

Nationwide access, local support” is the unique premise, and promise, of the Blue Cross and Blue Shield companies: healthcare specially tailored to the needs of the local communities where our Blue members live and work, but with access to our national network wherever they may travel.

How do I contact a blue card?

Phone
  1. 8am–5pm Monday to Friday*
  2. 1800 113 611 (freecall in Queensland)
  3. (07) 3211 6999.
  4. +61 7 3211 6999 (international)

What is blue card in US healthcare?

BlueCard is a national program that enables members of one Blue Cross and Blue Shield (BCBS) Plan to obtain health care services while traveling or living in another BCBS Plan's service area.

Does EPO cover out of state?

EPO stands for "Exclusive Provider Organization" plan. As a member of an EPO, you can use the doctors and hospitals within the EPO network, but cannot go outside the network for care.

Do EPO plans require authorization?

You Will Be Required to Get Pre-Authorization for Expensive Services. Your EPO will likely require you to get permission for some services, especially those which are most costly. If a particular service requires pre-authorization (prior authorization) and you don't get it, your EPO can refuse to pay.