How does the BlueCross BlueShield PPO work?

The BCBS PPO plan is an 80/20 coinsurance plan with copays that allow you the flexibility to select your physicians without referrals. After the annual out-of-pocket maximum has been met, you will continue to pay your copay, but your coinsurance level will be 100%. To receive the maximum benefits you should use an in-network provider that participates in Network P. You may contact BCBS or visit their website for a list of in-network providers. If you choose to use an out-of-network provider, you will still receive benefits, but at a lower level (60/40) and you may be required to pay the entire bill up front and file a claim with BCBS for reimbursement.

Prescription drug coverage is provided by BCBS and is available through most retail and home delivery pharmacies. You may obtain a 34-day supply for the cost of one copay and a 35- to 102-day supply for the cost of two copays which may be filled at certain retail pharmacies or through home delivery and mail order programs. The generic drug copay is considerably less than the copay of a brand name drug.