BCBS Individuals: Out-Of-Town Coverage Changes
With the new plan year just a couple weeks away, The Insurance People want to remind our BCBS Individual Market clients that starting January 1, 2025: Blue Choice Preferred PPO and MyBluePlus POS plan members will no longer have access to out-of-state health care except for border counties of Illinois’s contiguous states, Indiana, Wisconsin, Iowa, Missouri, and Kentucky.
How Will This Change Affect My Care?
There are several scenarios in which this may affect BCBS Individual plan members:
People who spend significant time living and/or working in other states throughout the year (snowbirds, remote workers, etc.)
College students who attend universities outside their home state of Illinois
People with complex medical needs who seek quality care at out-of-state medical clinics and hospital groups (Mayo Clinic, Cleveland Clinic, etc.)
People who work out-of-state and utilize providers near work who are beyond border counties of neighboring states
What You Can Do To Receive Care
The most important thing to remember is that if you are in need of urgent care or emergency services, your BCBS Individual plan will still cover those services in any of the United States.
This change also DOES NOT AFFECT ANY GROUP MARKET CLIENTS.
To continue receiving care from out-of-state, out-of-network providers, you must request a waiver for your care. If the waiver is granted, the care will be reimbursed as in-network providers are. If no waiver is granted, you are responsible for the full cost of the care you seek.
To learn more about the changes that will go into effect, visit BlueCross BlueShield of Illinois here. Have additional questions about how this will impact your care? Contact us today.
