The plan leverages organized systems of care to offer members unique access to the PPO network at lower costs. OSCs are communities of doctors and hospitals within the Blue Cross PPO network who work together to provide the highest level of customized, coordinated care that’s right for each patient.
Many OSCs are designated as a Level 1, based on their level of care at the lowest cost. Other OSCs will provide the same high-level of care to you and your family, but not at the lowest cost.
As a Physician Choice PPO member, to receive the lowest costs you’ll select a primary care doctor in a Level 1 OSC for each member on your plan. Out-of-pocket costs will vary based on where you choose to receive care (such as a hospital, urgent care clinic or specialist).
A Guide to Physician Choice PPO Costs
Physician Choice PPO plans have various cost sharing levels, starting with the lowest at Level 1.
- You’ll pay Level 1 cost share by choosing a primary care doctor in a Level 1 OSC and using doctors or hospitals within your OSC
- You’ll also pay Level 1 cost share if you receive a referral from your primary care doctor to use a doctor or hospital outside of your primary care doctor’s Level 1 OSC but within the PPO network
- If you use a provider in another OSC or elsewhere within the Blue Cross PPO network without a referral from your doctor, you’ll pay a Level 2 cost share
- You’ll pay the highest costs if you select doctors and hospitals outside the Blue Cross PPO network
Physician Choice PPO combines the ability of full choice and control of traditional PPO plans, with the added benefit of coordinated care. Contact an agent at 1-888-899-4931 to get started with your plan.