This prefix is linked to a POS plan. Point of Service coverage gives members a choice at the time of service: use the HMO-style in-network benefit with a referral for lower costs, or access out-of-network providers at reduced coverage levels. The billing approach depends on which option the member chooses.
This is a High-Deductible Health Plan (HDHP) prefix. These plans have minimum deductible thresholds set by the IRS. Members often use HSA funds to cover out-of-pocket costs. The plan's claims processing and payer ID are the same as the standard plan, but expect higher patient responsibility amounts on remittance.
This prefix includes Medicaid managed care coverage. The BCBS plan administers Medicaid benefits on behalf of the state. Claims submission, prior authorization, and reimbursement rules may follow state Medicaid guidelines rather than the plan's standard commercial policies. Confirm the correct payer ID for Medicaid claims.
State's only statewide customer-owned health insurer and independent licensee of the Blue Cross Blue Shield Association. Serves Illinois with commercial, Medicare, Medicaid and other plans.