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Plan Type Preferred Provider Organization (PPO) Managed Care Consumer-Directed
Plan Name  Alliance SelectSM Copayment Alliance Select Coinsurance Alliance Select Primary Alliance Select Premium Saver Blue Choice® Blue Access® Blue Advantage® Blue Priority HSASM Blue Priority HRASM

How Plan Works

Uses flat-dollar copayments for office-based services.

Uses coinsurance for office-based services. Employees pay a certain percentage of the provider’s billed charge.

Uses a tiered copay design for office visits. Employees generally pay for a lower copay for primary care and a higher copay for non-primary care.

Uses a tiered copay design to help keep costs down. Employees generally pay a lower copay for primary care and a higher copay for non-primary care.

Requires selection of a primary care provider (PCP). Out-of-pocket costs are generally lowest when employees see their PCP, but they can see any physician for most services.

Allows employees to see any provider in the network without a referral. Employees are not required to choose a PCP, however, employee costs are generally lower for office services from seven types of primary care providers.

Requires selection of a primary care provider (PCP), who serves as the starting point for all health care.

Combines a high-deductible PPO health plan with a health savings account (HSA). The HSA can be used to pay for medical expenses until the deductible is met.

Combines a high-deductible PPO health plan with an employer-funded health reimbursement account (HRA). The HRA reimburses employees for covered health care expenses.

Network

Alliance Select Network: 100% of hospitals and 99% of physicians in Iowa.

Wellmark Health Plan of Iowa: 100% of hospitals and 97% of physicians in Iowa.

Alliance Select Network: 100% of hospitals and 99% of physicians in Iowa.

Network Out of State

BlueCard® Network: More than 90% of hospitals and 80% of doctors in the U.S.

Blue Card Network: For emergency care only.

BlueCard® Network: More than 90% of hospitals and 80% of doctors in the U.S.

Coverage Out of Network?

Yes

 

No

Yes

Referrals Required?

No

Yes

No

Prescription Drug Coverage Included in Plan

Blue Rx PreferredSM: Employees pay copayment for prescriptions. Uses tiered copay structure to encourage use of generic or lower-priced drugs. 

Covered under health plan. Employees pay full cost of prescriptions and are reimbursed once they meet their deductible.

Blue Rx PreferredSM: Employees pay copayment for prescriptions. Uses tiered copay structure to encourage use of generic or lower-priced drugs. 

Health & Wellness

All plans include Health & Wellness Programs 

 
 
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Wellmark Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association doing business in Iowa and South Dakota.
 
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