HMO (Health Maintenance Organization) plans require members to choose a primary care physician (PCP) and obtain referrals before seeing specialists. Out-of-network services are generally not covered except in emergencies. Claims must be submitted to the payer listed above and should include referral authorization when applicable.
Nonprofit health insurance company serving seven million members nationwide with strongest presence in Philadelphia area and Southeastern Pennsylvania. Member of the Blue Cross Blue Shield Association for over 85 years.