Members

The BlueCard® Program

The Blue Card

As a member of an Arkansas Blue Cross and Blue Shield-affiliated health plan, you may participate in the national BlueCard program. The BlueCard program allows members to receive healthcare benefits while traveling or living out of their Plan's area. Members also enjoy the convenience of having access to the Blue Cross Blue Shield Global Core® network of participating hospitals. If you live in Arkansas, benefits under your plan may be reduced or restricted outside the state. If you live outside of Arkansas, benefits will be based on your benefit plan. Please consult your benefit booklet or contact customer service for specific benefit information.

The BlueCard program has four components:

1. National Coverage

More than 85 percent of all hospitals and physicians throughout the United States contract with Blue Cross and Blue Shield Plans. The BlueCard program links each of these healthcare providers.

2. BlueCard PPO

PPO BlueCard PPO links Blue Plan Preferred Provider Organization (PPO) network doctors and hospitals to Blue Plans throughout the United States.

If you or your family are traveling or living in another Blue Plan's area temporarily, you can present your ID card to any BlueCard PPO doctor or hospital. An estimated 95 percent of the U.S. population lives in areas covered by Blue Cross and Blue Shield PPOs.

BlueCard doctors and hospitals will recognize your BlueCard PPO membership by a special "PPO in a suitcase" symbol on your ID card. You do not need to fill out a claim form for this service.

3. Traditional BlueCard

You may have in-network health plan benefits outside the state of Arkansas only for medical emergencies while you are travelling. If your ID card displays an empty suitcase logo, you have BlueCard coverage called "Traditional BlueCard." You have access to the BlueCard Traditional provider network (not the PPO network). When looking for providers within this network, be sure to use your BlueCard alpha prefix.

4. Coverage Abroad

Blue Cross Blue Shield Global Core lets you use your ID card to receive covered inpatient care at participating hospitals in many countries around the world. Blue Cross Blue Shield Global Core participating hospitals are located in major travel destinations and business centers throughout the world. When you're traveling or living outside the United States and require inpatient hospital care, show your ID card to any of these participating hospitals.

Finding a Provider

Simply pull out your ID card and call BlueCard Access® at 1-800-810-BLUE (2583) for the names and addresses of participating doctors and hospitals in the area where you are traveling or living. If you are traveling abroad, you can use the toll-free number outside the United States by using an AT&T Direct® Access Number.

To find a BlueCard healthcare provider anywhere from coast to coast and to view a map with detailed driving instructions, see the National Doctor & Hospital Finder.

How the BlueCard Program Works

  1. Always carry your most current ID card.
  2. When you're outside your Plan's area, pull out your ID card and call BlueCard Access at 1-800-810-2583 for information on the nearest Blue Cross and Blue Shield doctors and hospitals in the area where you're traveling or living. For other questions, call the Customer Service number indicated on your ID card.
  3. For precertification or prenotification requirements of your Plan, use the telephone number indicated on your ID card.
  4. When you arrive at the doctor's office or hospital, present your ID card, and the doctor's office or hospital will verify your membership and coverage.
  5. After you receive medical attention, your claim is routed to the Host Plan (Blue Plan of the state where services were rendered), which, in turn, submits to the Home Plan (the Plan that handles claim processing for your group).
  6. All participating providers are paid directly, relieving you of any hassle or worry. You usually will need to pay only for out-of-pocket expenses (noncovered services, deductibles, copayments or coinsurance).
  7. BlueAdvantage Administrators of Arkansas will send you a detailed Explanation of Benefits.

Emergencies

In case of a life-threatening emergency, seek immediate care from the nearest provider.

"Medical Emergency" is defined as follows: medical care and treatment provided after the sudden onset of a medical condition that manifests itself by acute symptoms, including severe pain. Symptoms are severe enough that, in the judgment of a reasonable person, the lack of immediate medical attention could reasonably be expected to result in any of the following:

  • The patient’s health would be placed in serious jeopardy; or,
  • Bodily function would be seriously impaired; or,
  • There would be serious dysfunction of a bodily organ or other part of the body.

Nonparticipating Provider

You may have the option of using a nonparticipating hospital or doctor, but you may have to pay that provider directly and then file a claim with BlueAdvantage for reimbursement of covered expenses. Also, a nonparticipating provider may not accept the usual and customary charges; therefore, you would be responsible for any amount over the allowance. Coverages may vary, so call Customer Service at the number on your ID card or email BlueAdvantage Customer Service for details.

Contact your employer or call the Customer Service number on your ID card to determine if you participate in this program. The Blue Cross and Blue Shield logo and a suitcase emblem will be displayed on your ID card to indicate participation in the BlueCard program.