Why Blue Cross® Physician Choice PPO Works for Your Business

by bcbsm

| 3 min read

Blue Cross® Physician Choice PPO, Blue Cross Blue Shield of Michigan’s new, innovative product, leverages the unique Organized Systems of Care (OSC) model to offer a wide range of services to our members. This plan encourages members to become active participants in their health, which helps them receive high-quality, coordinated care with lower out-of-pocket costs. This plan doesn’t just benefit members, though. Blue Cross® Physician Choice PPO also helps employers reduce health care costs while continuing to give your employees choices. With this plan, businesses can save as much as nine percent off premiums compared to other PPO plans with comparable coverage. And that’s not all. Here are just some of the other features that set Blue Cross® Physician Choice PPO apart from other plans: More than Just In-Network or Out-of-Network While many other plans just have two choices—a doctor is either in-network or out-of-network—Blue Cross® Physician Choice PPO offers members three cost sharing levels to give them ultimate flexibility. They will pay the lowest amount if they pick a primary care doctor within a Level 1 OSC and see specialists within the same OSC (this is Level 1 cost share). They will pay a little more if they see a doctor or hospital in the Blue Cross PPO network (this is Level 2 cost share). They will pay the most if they see a doctor not contracted with Blue Cross (this is out-of-network cost share). [video width="1920" height="1080" mp4="https://www.mibluesperspectives.com/wp-content/uploads/2017/01/Blue-Cross-Physician-Choice-PPO-_-PCPPO-Cost-Sharing-Levels-Explained-Master-V5.mp4"][/video] Members Choose What’s Important One of the key benefits offered by Blue Cross® Physician Choice PPO is that it represents the best of both worlds between HMO and PPO plans. It has the flexibility of a typical PPO plan (members aren’t required to pick a primary care physician) and the coordinated care and cost-saving benefits of an HMO (a member who selects a primary care physician and sticks to level 1 cost sharing can maximize savings). [video width="1920" height="1080" mp4="https://www.mibluesperspectives.com/wp-content/uploads/2017/01/Blue-Cross-Physician-Choice-PPO-_-PCPPO-Introduction-and-FAQs-Master-V4.mp4"][/video] Referrals Aren’t Always Needed If a member wants to see a specialist within the same Level 1 OSC as their primary care physician, there’s no need to get a referral. A referral is only required if a member wants to stick to Level 1 cost share and see a specialist outside of their Level 1 OSC. That said, members can see any doctor or specialist outside of their Level 1 OSC without a referral, they will just pay more. [video width="1920" height="1080" mp4="https://www.mibluesperspectives.com/wp-content/uploads/2017/01/Blue-Cross-Physician-Choice-PPO-_-PCPPO-Finding-a-Level-1-Doctor-Getting-a-Referral-MASTER-V5.mp4"][/video] Blue Cross® Physician Choice PPO provides members with options and access unlike any other plan. To learn more, visit:
For more information on Blue Cross® Physician Choice PPO click here. Photo Credit: Natural Building Tech

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MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association