New York • PPO, Traditional Indemnity, High-Deductible Health Plan (HDHP)
Under this PPO prefix, members are covered for both in-network and out-of-network care. The plan pays a higher percentage of allowed charges when members use participating providers. No gatekeeper or primary care referral is required. Verify the member's specific benefits for cost-sharing details.
Traditional indemnity coverage under this prefix is a fee-for-service plan. Members can see any provider without network restrictions or referral requirements. The plan reimburses a set percentage of usual and customary charges. Claims are submitted directly to the payer listed above.
Under this HDHP prefix, the member's plan has a higher deductible than traditional coverage. This affects patient cost-sharing but does not change how claims are submitted or processed. Use the same payer ID, claims address, and filing procedures listed above. Verify the member's remaining deductible before estimating patient responsibility.
Part of the Blue Cross Blue Shield Association, serving New York members with commercial, Medicare and Medicaid plans.