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How your plan works
An Independence Blue Cross health plan lets you visit any doctor or hospital in the network, and some plans also give you options for out-of-network coverage. Here are some other key things you should know.
Primary Care Physician (PCP)
Our HMO and POS plans require you to choose an in-network PCP, or family doctor, to treat your general health needs and coordinate your care by providing referrals, when necessary. Search for a PCP at ibx.com/findadoctor.
Specialist
If you have an HMO plan, you can see any in-network specialist when your PCP submits an electronic referral. You can check the status of your referrals anytime when you log in at ibx.com. There are some services you don’t need a referral for, including gynecology, mammograms, behavioral health, and emergency care. If you have a PPO plan, you don’t need a referral to visit a specialist.
Designated sites
Some plans require you to receive certain in-network services (like blood work and X-rays) at a specific site, while other plans offer cost-savings for doing so. Learn more at ibx.com/waystosave.
Out-of-network benefits
With an HMO plan, out-of-network benefits are covered for emergency care only. With a POS or PPO plan, you have the option for in- and out-of-network care, but you’ll pay less in the network. PPO plans also have in-network coverage across the U.S. through BlueCard® PPO, with 95 percent of doctors and hospitals accepting your Independence Blue Cross ID card.
Precertification
Precertification is an approval that your doctor must receive from us before you get coverage for certain services, genetic tests, and specialty drugs. A complete list of what requires precertification is available at ibx.com/precert.
Virtual care
Many health plans now include 24/7 access to a doctor by phone, video chat, or mobile app. Check your benefits summary to see if virtual care is available to you.