Benefits 101: A Guide To Getting Medical Care

Taylar Kobylas

| 2 min read

Every year, the "new year, new you," conversation rolls around and the first step usually means getting healthy. Whether it's setting a realistic goal or just making it to the doctor, every little bit counts. Having healthcare coverage is a great start, but do you know how to use it? There's medical care you can anticipate, and medical care that you can't. Both can be stressful, but understanding your benefits and planning ahead of time can make the situation a whole lot easier. If you're a Blue Cross or Blue Care Network member, log into bcbsm.com to learn what your plan covers, review your claims status and history, and even estimate treatment costs*. The chart below outlines the different types of care, and what to do when you need it. A quick rule of thumb: Always call your doctor first, unless it's an emergency. Not only does your primary care physician (PCP) handle routine checkups, but their also the best first point of contact for injuries, symptoms and medical questions.
Now you know when and how to access medical care at your primary doctor's office, an urgent care center, an emergency room and at a hospital. But what about when you're traveling? Doctors and hospitals that contract with Blues plans nationwide participate in BlueCard, our care program when you’re away from home. If you're eligible for pharmaceutical care, you can also fill prescriptions at any Blues-participating pharmacy when you travel.
A final set of services to know about are behavioral health. Behavioral health care management varies, but most plans provide coverage for mental health and substance abuse care. Other types of conditions that cause emotional or mental distress are also covered, such as life adjustment issues and depression.
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*Cost estimates are for PPO members only. Photo credit: Morgue File

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