Page 6 - Affinity Neurocare Benefit Guide 2022 updated

BCBS HMO Brief Q&A:

Assigned PCP and Referral Applies to HMO’s Only

what you need to BCBS Advantage Plans

When you enroll in Advantage HMO Plan , get a primary care physician CP) from the network, who help guide you through the health care sys-
tem. PCP to know you, helps manage your health care and you to specialists, save time and money when you get your care from a
network
This help you your plan so you can get the out of your medical benefits. Or you can find information online at www.bcbstx.com/member/account-
access/mobile/log-in

do need to a CP?
When you enroll in the plan, you must select a PCP from our network to help you your health and get the care you need. PCP provides
regular and routine care, annual k you to other network physicians or specialists when additional care is are required get an
electronic from your physician before you see another network PCP or specialist. electronic your may be a lot higher or they may
not be covered at all. Check your plan more information.

How do a CP?
You can go to www.bcbstx.com/find-care/providers-in-your-network/find-a-doctor-or-hospital
and use the physician search tool, available in English and Spanish, to find a PCP in your plan’s network. If you do not choose a PCP or you pick a physician who
is far from where you live or who is not a general practice physician, family practice physician, pediatrician or internal medicine physician, we will assign one to you.

Can each covered family member have his or her own CP?
can select one physician your entire or each covered member may select his or own physician. Please check your
before enrolling to confirm that he or she is new patients and there are any patient age

Can any type of physician my CP?
PCP must be a general practice physician, practice physician, pediatrician or internal medicine

my PCP be identified on my health plan ard?
The name and telephone number be listed on each health plan card. Be
and check the PCP name on your card to ensure is your intended PCP. you want to change from the
listed on the card, please contact the Customer Care number on your card or go to www.BCBSTX.com

Can a covered family member living out of a PCP closer to he or she
No. members must choose a PCP in the town or near where you (the subscriber) This students going to school out of state, or
children another

enroll, can change my CP?
PCP can be made once a month and are the of the month. requests can be submitted on or the 31st of the
month. Changes can be made by Customer Care number on your card or by logging on to www.BCBSTX.com New health plan cards will be
issued whenever members change their

Are there any can see without a
are not to see the providers as long as they are in the
• (OB/GYNs).
• Behavioral health or use disorder clinicians.
• Convenience care clinics.
• Urgent care clinics.
• Designated network
Remember: Emergencies are covered anywhere in the including non-network hospitals, without should validate that a has been entered
prior to seeing a network physician or specialist by checking on www.BCBSTX.com or calling Customer Care at the number on the
Do need a before a
important that you get an electronic from your PCP before you see another network including specialists. should validate that a has
been entered prior to seeing a network physician specialist by checking on www.BCBSTX.com or calling Customer Care at the number on your

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