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Benefit Design 

If you are a member enrolled in a benefit design that provides for a lower copayment amount when services are received from a Primary Care Practitioner, please review the following notice. To determine if your benefit design provides for a lower copayment amount when services are received from a Primary Care Practitioner, refer to your Benefits Certificate.

IMPORTANT: For purposes of determining your copayment responsibility, Alliance Select, Blue Select, and Blue Card PPO providers are classified by Wellmark as either Primary Care Practitioners or Non-Primary Care Practitioners. In order to determine whether the Primary Care Practitioner or Non-Primary Care Practitioner copayment applies, you should contact Wellmark’s customer service department in advance of receiving any services to determine whether your provider is classified by Wellmark as Primary Care Practitioner or Non-Primary Care Practitioner for purposes of your copayment responsibility. 

Please Note: The classification of providers in the Wellmark Provider Directory does not control whether a provider is a Primary Care Practitioner or Non-Primary Care Practitioner for purposes of your copayment responsibility. For example, a provider might be listed under multiple specialties in the Provider Directory, such as Internal Medicine or Oncology, but would be classified by Wellmark as a Non-Primary Care Practitioner for purposes of your copayment responsibility.