New York • High-Deductible Health Plan (HDHP), Traditional Indemnity, Medicaid
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.
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.
Medicaid managed care under this BCBS prefix means the state has contracted with this plan to administer Medicaid benefits. Balance billing Medicaid members is prohibited. Timely filing requirements may follow state Medicaid rules rather than the plan's commercial deadlines. Contact the plan to confirm submission requirements.
Part of the Blue Cross Blue Shield Association, serving New York members with commercial, Medicare and Medicaid plans.