New HMO Plan Gives Michigan Consumers the Freedom to Self-Refer to Any Doctor: In or Out of Network

State of Michigan Welcome SignBlue Care Network’s new HMO plan allows patients to self-refer to any doctor whether the doctor is in or outside the network.

In most HMOs, a network of contracted doctors and hospitals provides health care to HMO members who select a primary care physician. This primary care physician then provides and coordinates medical care. Traditionally, HMOs, or health maintenance organizations, do not provide coverage for medical services considered out of network. When health care is not coordinated through the HMO member’s primary care physician, the patient assumes responsibility for the total cost.

Blue Care Network’s Blue Elect Plus HMO is different.

Member-Driven

Blue Elect Plus allows members to self-refer to any doctor without a referral, giving employees more freedom of choice than traditional HMOs. It is replacing the Blue Elect Self-Referral OptionSM, which offers limited self-referrals to BCN-approved doctors.

With BCN’s Blue Elect Plus no referrals are needed – ever – whether the doctor is in or out of network. Members pay the least when a doctor or service provider is in BCN’s network.

Managed Care Made Flexible

We heard from Blues agents that customers love the benefits of managed care but wanted a product that offers more flexibility, explained Kathleen Pierce, BCN product development manager.

All in all, we think we have a product that’s right for groups of all sizes, across Michigan, according to Pierce. In one week since launch, agent feedback has been 100 percent positive. “We’re committed to developing the right products at the right time.”

Attractive and Affordable

To make Blue Elect Plus even more attractive, the company rolled in 100 percent coverage of some popular benefits.

Blue Care Network and BCBSM

Blue Care Network is Blue Cross Blue Shield of Michigan’s subsidiary that administers HMO plans for customers. An HMO is a type of managed care organization that focuses on maintaining and improving health.

Other BCN products for individuals include BlueCaid, MyBlue Medigapsm and OneBluesm. For employers and group customers, BCN has several options, including:

To find an agent who can help you select the right health insurance plan for you or your business, contact us.

Photo credit: jimmywayne

About Shannon Paul
Social Media Strategist at Fifth Third Bank. This is a personal profile. Comments and activity are personal and do not represent my employer.

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