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BluePreferred® Convenience Plus
BluePreferred offers numerous affordable options with a range of deductibles. As the mid-range offering in the BlueChoices suite, members enjoy higher benefit levels and numerous conveniences. These include predictable copayments for high-demand services such as preventive care and office visits. Like BlueEssentials, BluePreferred promotes cost-sharing between employer and employee with mid-range deductibles and the availability of a flexible spending account. BluePreferred is ideal for employers seeking a balance of affordability with extended coverage for members.

Download benefits summaries with full descriptions of each plan.

The snapshot below provides only a partial summary of benefits. Refer to the Benefits Booklet for a complete description of benefits, exclusions and limitations.

For BluePreferred January 1, 2006
A $3,000 deductible option is added

BluePreferred®
 
In-network
Out-of-network
Lifetime Maximum
$2,000,000
Provider Networks
  • With Access, out-of-network providers can bill members for uncovered balances
  • With Participating, out-of-network providers will be paid at our allowable amount, not billed charges

Participating
Preferred Provider Plan
Access
Deductible

$300
$500
$1,000 (HRA available for groups 51+)
$2,000 (HRA available for groups 51+)
$3,000 (HRA available for groups 51+)

Coinsurance
80%
60%
Maximum Coinsurance
Must meet separate maximum coinsurance amount for out-of-network – not a combination of the in- and out-of-network
$2,000
$8,000
Family Deductible
Three individual family members must meet the deductible (no family aggregate)
Preventive Services
Annual Women’s Exam
Includes pap and mammogram
$20 copay
Deductible and coinsurance apply
Immunizations
Adult and children
$10 copay
$10 copay
Well Baby Care
To age 2
$20 copay
Deductible and coinsurance apply
Routine Health Exams

- $20 copay
- $200 limit, includes DRL
Not covered
Professional Services – copays and deductible waiver apply to in-network only; out-of-network subject to deductible and coinsurance
Office Visit
  • With immunization, additional $10 copay collected
  • If more than one office visit per day, applicable copay collected for each visit
    		• Personal physician: $20 copay
    		• Specialist: $40 copay
    		• Above copays for office visits only
    		• All other office services subject to deductible and coinsurance
    Deductible and coinsurance apply
    Outpatient DRL (Diagnostic Radiology & Lab )
    • Includes DRL in an outpatient setting, such as an emergency room
    • Does not apply to preventive services
    		First $500 of DRL covered at 80% per calendar year with no deductible, then deductible and coinsurance apply
    Deductible and coinsurance apply
    Maternity
    		• Initial visit $20 copay, then deductible and coinsurance apply
    • DRL subject to deductible and coinsurance
    Deductible and coinsurance apply
    Urgent Care Professionals
    • Personal Physician: $20 copay
    • Specialist: $40 copay
    • Above copays for office visits only
    • All other office services subject to deductible and coinsurance
    Deductible and coinsurance apply
    Facility Benefits
    Inpatient/Residential Facility Care
    • Surgery and related services
    • Related services and supplies
    • Maternity care
    • Skilled nursing facility (SNF)
    • Inpatient rehabilitation

    • Deductible and coinsurance apply
    • Payment is limited to semi-private room rate
    • SNF is limited to 14 days. If authorized by health plan the benefit may be increased to 100 days.
    Outpatient Facility Care
    Surgery and Related Services
    Deductible and coinsurance apply
    Emergency Room
    • Copay waived if admitted to the hospital
    • If true emergency, regardless of location, the in-network benefit applies for facility and professional. If hospitalized, out-of-network benefit applies.
    • For Preferred Provider Plan and Preferred Care Network, out-of-network benefit and hold harmless apply for true emergency
    $100 copay, deductible and coinsurance apply
    Miscellaneous Benefits
    • Hospice services
    • Durable medical equipment and supplies, prosthetic and orthotic devices
    • Outpatient and listed in facility rehabilitation services
    Deductible and coinsurance apply
    Chemical Dependency/Mental Health
    • Oregon mandates apply
    • In-network: Personal Physician $20 copay / Specialist $40 copay; Out-of-Network: deductible and coinsurance
    • Above copays for office visits only
    • All other services subject to deductible and coinsurance
    • 45-day limit per calendar year for mental health residential treatment
    Special Beginnings® Prenatal Education Program
    Included
    BlueCard® Program
    Nationwide coverage through the one-of-its-kind program
    Included
    Accidental Death
    $25,000 per employee and enrolled spouse; $5,000 per enrolled dependent child

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