BlueLincs HMO

With BlueLincs HMO, budgeting for your health care needs is easy. You'll have low out-of-pocket expenses!

There's no deductible to meet. You pay only a small physician's office copayment for most services, such as:

• Immunizations
• Periodic physical exams
• Well-baby and well-child care
• Annual vision and hearing screening (to age 19)
• Surgical procedures in your physician's office
• Allergy testing

As a BlueLincs HMO Member, you choose a physician for yourself and each member of your family from hundreds of Primary Care Physicians (PCP).

Your Primary Care Physician is your personal health care consultant, working with you to coordinate all your health care needs. Think of your PCP as a knowledgeable resource in today's complex health care environment.

If you need a specialist's expertise, your PCP can refer you to one of the many specialists in the BlueLincs HMO network.

You decide what's best for you — a doctor near your job? Home? Child's school? It's up to you. Consult the Provider Finder^® to find a physician in the BlueLincs HMO network who best fits your needs!

Planning a vacation? Make sure your health benefits go with you when you're away from home. BlueLincs members can use the BlueCard^® program to find care outside the BlueLincs service area.

With the BlueCard program, HMO members can use the Provider Finder^®, 24-hours-a-day, at 1-800-810-BLUE or by visiting http://www.bcbs.com/. Members pay required copayments or deductibles, and claims are filed for the member by the health care provider. All routine or follow-up care must be pre-arranged by the member's primary care physician before the member leaves town.

There are never any claims to file for routine care, when your care is coordinated by your BlueLincs HMO Primary Care Physician.

When you visit your doctor, you pay only a small office copayment. And if you need a prescription, a prescription copayment is all you owe.

You receive the health care you need, and BlueLincs HMO handles the paperwork. That's real convenience — and savings!

BlueLincs HMO has received health plan accreditation from URAC — a non-profit organization issuing more than 2,000 accreditation certificates to more than 500 managed care organizations in all 50 states and Canada. URAC accreditation standards are recognized nationally as providing the benchmarks for quality in managed care organizations.

BlueLincs Plan H, Value Option and Special Option give employers more choices to save on premiums. In addition to no deductible plans, annual deductibles of $200, $300, $500 and $1,000 are available.

BlueLincs Plan H (BlueLincs' most popular plan)

Features for BlueLincs Plan H include:

• Primary care physician office visits are fully covered, with just a $20 office visit copayment.
• 20 percent copayments for most other health care services.
• For deductible plans: If the copayment is based on a percentage, then the deductible applies before the copayment. If the copayment is a dollar amount, then the deductible applies after the copayment.
• Inpatient care is $100 copayment per day per admission, for the first 5 days then no charge.
• The annual maximum out-of-pocket amount a member pays under BlueLincs Plan H is $2,000.

BlueLincs Value Option

Features for all BlueLincs Value Option plans include:

• Primary care physician office visits are fully covered, with just a $20 office visit copayment.
• 20 percent copayments for most other health care services.
• For deductible plans: If the copayment is based on a percentage, then the deductible applies before the copayment. If the copayment is a dollar amount, then the deductible applies after the copayment.
• The annual maximum out-of-pocket amount a member pays under BlueLincs Value Option is $2,000.

BlueLincs Special Option

Features for all BlueLincs Special Option plans include:

• The lowest premiums of any BlueLincs HMO plan.
• Primary care physician office visits are fully covered, with just a $20 office visit copayment.
• Specialist office visits fully covered, with just a $30 office visit copayment.
• 30 percent copayments for most other health care services.
• For deductible plans: If the copayment is based on a percentage, then the deductible applies before the copayment. If the copayment is a dollar amount, then the deductible applies after the copayment.
• The annual maximum out-of-pocket amount a member pays under BlueLincs Special Option is $3,000.