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Blue
Advantage®
A Primary Care Health Product
Blue Advantage is for those employers who want a high degree of control
over health care costs, while providing employees the advantages of a
personal physician to coordinate care.
As the group administrator of a large employer group, you have great
flexibility in customizing a Blue Advantage plan to meet your group's
unique needs. You can customize:
- Deductibles
- Coinsurance amounts
- Covered and noncovered services
- Prescription drug coverage
Five Points You Need to Know About Blue Advantage:
- Care coordinated through a primary care provider. Your employees
and their dependents must designate a primary care provider (PCP) in
the Wellmark Health Plan of Iowa network to provide or coordinate their
care. Women
may also designate an OB/GYN.
- Preventive services covered. Blue Advantage
emphasizes preventive care with benefits designed to keep your
employees healthy — which
translates into a healthier workforce
for you and helps control health care costs. These
preventive benefits include routine physicals, well-child care, immunizations,
mammograms, and well-female exams. Benefits
for preventive care services are only available when those services
are provided by the member's
designated PCP or OB/GYN.
- Use network providers. To receive benefits, members must visit
providers who participate in the Wellmark Health Plan of Iowa network,
which includes 96 percent of hospitals and 88 percent of the physicians
in Iowa. If their PCP refers them to a specialist, they
must make sure the specialist
participates
in the network before their appointment.
- Prescription drug plan included. Blue Rx Preferred prescription
drug coverage has a three-tier copayment structure to encourage your
employees to use
generic or lower-priced drugs.
Different copays apply for generic drugs, specially selected brand
name drugs, and all other brand name drugs. Blue
Rx Preferred provides convenient access to a large pharmacy network
that includes both national retail chains and independent
pharmacies.
- Coverage for routine vision exam. Because Wellmark is committed
to total health, we include coverage for
a routine vision exam in all Blue Access health plans and offer
separate vision options
as well.
Contact your Wellmark account manager or
broker to find out if Blue Advantage meets your needs.
Please note: This information is only a summary of the benefits of Blue
Advantage health insurance coverage from Wellmark
Health Plan of Iowa; it is to be used for descriptive purposes only.
Benefits and general provisions described herein are subject to terms of
the actual policy and benefits certificate.
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