Blue Cross Blue Shield of Louisiana



Blue Cross Blue Shield of Louisiana is a not-for-profit health insurance company committed to offering coverage to fit your needs. They offer health insurance plans for individuals and families. Each plan features a range of payment and deductible options designed to fit your lifestyle and your budget. From PPOs and HMOs to consumer-directed health plans with health savings accounts, you are sure to find a Blue Cross plan that fits your life and your budget.

Blue Cross Blue Shield of Louisiana Individual Health Plans

BCBSLA offers five different plans to meet your coverage needs. Their plans offer the advantages of:

•  A large network of doctors and hospitals
•  Direct access to specialty care without a referral
•  Preventive and wellness services — most at no extra cost
•  Local customer service
•  Online tools to help you get the most from your health plan
•  An ID card recognized around the world
•  Exclusive member discounts and savings through Blue365
•  No lifetime maximum

BlueMax

BlueMax, is their most comprehensive individual major medical plan, helps pay for everyday medical expenses as well as hospitalization. This plan features an accredited statewide network of doctors and hospitals, plus savings for your pocketbook. They now offer plan options with a variety of deductibles and copayments to help you manage your healthcare costs.

Hospitalization and surgery coverage
• Physician office visits and copayment options
• Prescription drug program
• Preventive and wellness care
• Pregnancy care option
• Accidental death and dismemberment
• Limited oral surgery benefits

Coverage Options

Comprehensive BlueMax coverage options with affordable premiums help you manage your healthcare costs wisely. With BlueMax, you get the best of both worlds: maximum benefits with minimum worry — plus the predictability of copayments for doctor visits on most plans.

Here’s how it works:  you choose the deductible, and the amount you pay out-of-pocket. Each year when you meet your deductible your plan’s benefits kick in. If you have a family plan, you pay up to three deductibles. After you meet your deductible and an out-of-pocket maximum per calendar year we pay for covered expenses at 100 percent of the allowable charge.

Prescription Drug Coverage

Prescription drugs are available for a copayment when you use a network pharmacy or mail-service pharmacy. Different copayments apply for brand-name and generic drugs. Several high deductible options have a separate and additional prescription drug deductible.  (See policy.) If you have a plan with a pharmacy deductible, you will pay a copayment when you choose a network pharmacy or mail-service.

Pregnancy Care Option

This option provides coverage for pregnancy care at the same coinsurance level and deductible you select for major medical coverage.
•  You must add the pregnancy care option when you buy your policy or you can add it within 30 days of marriage or 30 days of your policy’s anniversary date. Consult your sales rep for details.
•  No maternity option is available for the $5,000 deductible.

If you do not add the pregnancy care option, your plan will still pay limited pregnancy benefits after you’ve paid $7,500 out-of-pocket for pregnancy-related care.

NOTE: Miscarriages and ectopic pregnancies are covered regardless of whether you choose the pregnancy option.

Blue Saver

Blue Saver is their high-deductible health plan, allows you to take control of your healthcare financing. With BlueSaver coverage and a health savings account (HSA) from a financial institution, you get sound, affordable health coverage while you build a financial cushion for your medical and non-medical needs.

The BlueSaver Package
• A choice of deductibles for individuals or families
• Out-of-pocket maximum includes deductible
• Pregnancy care option
• Prescription drug coverage
• Mail-order prescriptions, up to a 90-day supply
• Preventive and wellness benefits
• Emergency room coverage
• Doctors’ office visits for covered illness or injury

Plus These Expenses
• Hospitalization services
• Hospital visits by the doctor
• X-rays and laboratory tests performed in a doctor’s office or clinic
• Limited oral surgery benefits

Pregnancy Care Option
This option provides coverage for pregnancy care at the same coinsurance level and deductible you select for major medical coverage.
•  You must add the pregnancy care option when you buy your policy or you can add it within 30 days of marriage or 30 days of your policy’s anniversary date. Consult your sales rep for details.

You Will Need a Health Savings Account

A health savings account, or HSA, can be a valuable tool to help you save money for medical expenses. An HSA is a tax-free account that you open to pay qualified medical expenses. If you have BlueSaver you can open and contribute to an HSA. You can use money in your HSA to pay for deductibles and qualified medical expenses, such as doctor visits, hospital care and prescription drugs.

MySmart$aver from the Bancorp Bank* is our preferred health savings account designed to work seamlessly with BlueSaver.

Blue Select

BlueSelect features cost effective plans with basic hospitalization coverage, plus a few extra features like a prescription drug program and outpatient services.

Statewide PPO network

• Deductible choices from $500 to $5,000
• Covered surgery and hospital stays
• Preventive and wellness care
• Prescription drug benefits with separate deductible
• Inpatient and outpatient rehabilitation coverage
We’ve taken our most basic individual plan and enhanced it with features that our customers requested most – and priced it to fit their budgets.

Prescription Drug Coverage

Prescription drugs are available and subject to a separate deductible and coinsurance. Different coinsurance applies to brand-name and generic drugs.

BlueValue

The Blue Value policy features coverage for large, unplanned medical expenses, such as hospital stays and surgery. Valuable protection … just in case.

Statewide PPO network
• Deductible choices from $500 to $5,000
• Covered surgery and hospital stays
• Preventive and wellness care
• Inpatient rehabilitation services
• Outpatient rehabilitation (optional purchase)
• Covers chemotherapy drugs that are administered by IV infusion, injection and oral chemo drugs. (for cancer treatment only)

Since life can be as unpredictable as weather, it’s good to know there are some things you can count on — rain or shine.  The Blue Value policy is our most basic hospitalization coverage option. It features affordable protection for individuals and families.

Point of Service

Wholly owned by Blue Cross and Blue Shield of Louisiana, HMO Louisiana, Inc. is a subsidiary of the largest and most experienced health insurer in the state. We’re proud to bring you our managed care programs with the strength of the Cross and Shield.

Choice of five plans
• Prescription drug benefits
• Preventive and wellness care
• Out-of-area dependent coverage
• Deductible options for lower premiums
• Limited service areas and networks include Baton Rouge, New Orleans and Shreveport areas

The Point of Service (POS) plans feature predictable out-of-pocket costs with copayment plans for doctor visits, prescription drugs and hospital stays.

Non-Network Benefits

Our POS plans allow you to seek care outside of the network and still receive benefits. If you go to a doctor or hospital that isn’t in the HMO Louisiana network, you must pay a deductible. Once the deductible is met, you share the payment with us through coinsurance.

Dependent  Out-of-Area Benefits

For added convenience, our POS plans offer a benefit level for members with dependents — such as students — living outside of their designated service area. Enroll your dependents as “out-of-area” at time of application. These dependents receive all policy benefits, but subject to deductible/coinsurance.