Page 47 - Aegion PPO SPDs
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Check with Your Doctor or Provider.
If You need details about a Provider’s license or training, or help choosing a Doctor who is right for You,
call the Member Services number on the back of Your Member Identification Card. TTY/TDD services also
are available by dialing 711. A special operator will get in touch with us to help with Your needs.
The BlueCard Program
Like all Blue Cross & Blue Shield plans throughout the country, Anthem participates in a program called
"BlueCard," which provides services to You when You are outside our Service Area. For more details on
this program, please see “Inter-Plan Arrangements” in the Claims Payment section.
Copayment
Certain Network services may be subject to a Copayment amount which is a flat-dollar amount You will be
charged at the time services are rendered.
Copayments are the responsibility of the Member. Any Copayment amounts required are shown in the
Schedule of Benefits. Unless otherwise indicated, services which are not specifically identified in this
Benefit Booklet as being subject to a Copayment are subject to the calendar year Deductible and payable
at the percentage payable in the Schedule of Benefits.
Calendar Year Deductible
Before the Plan begins to pay benefits (except certain benefits which are subject to Copayment instead of
Deductible), You must meet any Deductible required. Deductible requirements are stated in the Schedule
of Benefits.
Identification Card
When You receive care from Your Network Provider or other Provider, You must show Your Identification
Card. Possession of an Identification Card confers no right to services or other benefits under the Plan.
To be entitled to such services or benefits You must be a Member on whose behalf all applicable Fees
under the Plan have been paid. Any person receiving services or other benefits to which he or she is not
then entitled under the provisions of the Plan will be responsible for the actual cost of such services or
benefits.
47
If You need details about a Provider’s license or training, or help choosing a Doctor who is right for You,
call the Member Services number on the back of Your Member Identification Card. TTY/TDD services also
are available by dialing 711. A special operator will get in touch with us to help with Your needs.
The BlueCard Program
Like all Blue Cross & Blue Shield plans throughout the country, Anthem participates in a program called
"BlueCard," which provides services to You when You are outside our Service Area. For more details on
this program, please see “Inter-Plan Arrangements” in the Claims Payment section.
Copayment
Certain Network services may be subject to a Copayment amount which is a flat-dollar amount You will be
charged at the time services are rendered.
Copayments are the responsibility of the Member. Any Copayment amounts required are shown in the
Schedule of Benefits. Unless otherwise indicated, services which are not specifically identified in this
Benefit Booklet as being subject to a Copayment are subject to the calendar year Deductible and payable
at the percentage payable in the Schedule of Benefits.
Calendar Year Deductible
Before the Plan begins to pay benefits (except certain benefits which are subject to Copayment instead of
Deductible), You must meet any Deductible required. Deductible requirements are stated in the Schedule
of Benefits.
Identification Card
When You receive care from Your Network Provider or other Provider, You must show Your Identification
Card. Possession of an Identification Card confers no right to services or other benefits under the Plan.
To be entitled to such services or benefits You must be a Member on whose behalf all applicable Fees
under the Plan have been paid. Any person receiving services or other benefits to which he or she is not
then entitled under the provisions of the Plan will be responsible for the actual cost of such services or
benefits.
47
