Anthem Blue Cross and Blue Shield of Wisconsin
Wisconsin • HMO, Traditional Indemnity, HDHP
HMO coverage means this member must use providers within the plan's network. A primary care physician serves as the care coordinator and must authorize specialist referrals. Emergency services are the primary exception to the network requirement. Always verify referral status before providing non-emergency specialty care.
This is a traditional indemnity prefix. Unlike managed care plans (HMO, PPO, EPO), indemnity plans do not use provider networks. There are no referral requirements and no restrictions on which providers the member can see. Submit claims to the payer listed above for reimbursement at the plan's allowed rate.
HDHP (High-Deductible Health Plan) coverage means the member has a higher deductible than traditional plans, often paired with a Health Savings Account (HSA). Most services require the member to pay out-of-pocket until the deductible is met. Preventive care is typically covered before the deductible. Submit claims normally to the payer listed above.
Independent licensee providing commercial, Medicare and Medicaid plans to Wisconsin members.