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Point-of-Service (POS)

With a Point of Service plan (POS), you decide how you want to balance choice and value every time you need care. A POS plan provides the flexibility to use your primary care physician or self refer to any Blue Cross Blue Shield participating provider. As long as your care is provided or arranged by your Blue Cross primary care physician, your out-of-pocket expenses will be minimal. You also have the freedom to seek care without seeing your PCP first. These are your self-referred benefits. When you self refer in Massachusetts, you may use any provider who participates with Blue Cross Blue Shield of Massachusetts. When you self refer outside of Massachusetts you may use any licensed provider. When you self refer your out-of-pocket cost will be greater. You are typically responsible for 20 percent coinsurance after the deductible, resulting in higher out-of-pocket costs. You may be subject to balance billing, claim form submission as well. Please call BCBSMA member service at 1-800-241-1263 for any further questions you may have regarding the use of your Blue Choice New England Plan.

Coverage is summarized below, but for
more detailed information on plan
coverages please refer to the POS
Summary of Benefits
.

Service
PCP Approved

Self-Referred Benefits

Office Visit
$15 co-pay
20% co-pay*
Routine Check-up
$15 co-pay
20% co-pay*
Hospital/Surgery
100%
20% co-pay*
Emergency Room
$50 co-pay
20% co-pay*

*Annual Deductible is $500 per individual and $1,000 per family, and the annual out-of-pocket maximum to employees is $1,000 per individual and $2,000 per family.

Blue Choice New England
(800) 241-1263
www.bcbsma.com
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