Blue Cross/Blue Shield of TN
Network for 2022
Blue Cross/Blue Shield issues two ID cards per household; however, additional cards are available upon request. The cards list the name of the head of contract, so family members use the same card for coverage. Members may request additional cards by phoning (800) 558-6213 or by logging onto the Blue Cross/Blue Shield website and printing a temporary card.
CVS Caremark is the pharmacy benefits manager. Call the CVS Caremark Call Center, open 24/7, at (877) 522-8679 to order a replacement card and for instructions on how to print a temporary card from the Caremark Website. You will be able to use your temporary card until your new card arrives.
Filling a prescription
Use a network pharmacy when filling prescriptions with up to a 30-day supply. The network includes more than 1,600 pharmacies across the state and chain pharmacies such as CVS, Kroger, Publix, RiteAid, Sam's, Target, Walgreens, and Walmart. Many local, independent pharmacies are also in the network.
Use the CVS Caremark Mail Service Pharmacy to fill your 90-day supply prescription or receive a 90-day supply from a participating retail pharmacy store. The mail-at-retail network will be different from the 30-day retail network.
In Network vs. Out of Network Providers
You can see any doctor or go to any health care facility you want. However, if you use an in-network provider, you will always pay less. That’s because an in-network provider agrees to provide services to our members at discounted rates. Non-network health care providers can bill you for any difference between actual charges and the approved amount plus any charges for services deemed not medically necessary or not authorized by BlueCross/BlueShield of Tennessee.
Services requiring copays are not subject to a deductible and do not apply to the annual out-of-pocket coinsurance maximum. Services requiring copays include preventive care (well-baby, well-child visits); adult annual physical; annual well-woman exam; immunizations as recommended by the CDC; primary care and specialist office visits; urgent care facilities; emergency room visit; x-ray and lab; prescriptions.
Some services require that you pay coinsurance after you meet a deductible. Coinsurance is a percentage of the total cost. Typical coinsurance charges include hospital stays; home care; ambulance services; advanced X-ray, scans, imaging; rehabilitation and therapy services.
A deductible is the amount you pay out of your pocket before the plan pays for hospital charges and other services that require coinsurance. It does not apply to services with a copay. Payments toward the deductible count toward the annual out-of-pocket maximum.
Out-of-Pocket Coinsurance Maximum
An out-of-pocket coinsurance maximum is the most you will pay for your deductible and coinsurance each year. It does not include your copays. Once you reach your out-of-pocket maximum, the plan pays 100 percent of covered medical expenses.
(800) 558-6213, Monday - Friday 8:00 am - 5:15 pm EST
Member Home Page
- Comparison of Health Insurance 2022 Plans
- 2022 Insurance Premiums
- 2022 Eligibility and Enrollment Guide
With Blue Access you can verify your benefits, check claim status, and order replacement cards.
The network for 2020 continues to be Network S. Find a provider by searching online or phone (800) 558-6213.
A 30-day supply prescription can be filled at a network pharmacy, which includes CVS, Kroger, Publix, RiteAid, Sam's, Target, Walgreens, Walmart and many local, independent pharmacies. Receive a 90-day supply prescription from the CVS Caremark Mail Service Pharmacy or from a participating retail pharmacy store. The mail-at-retail network will be different from the 30-day retail network.
What if I become ill outside the state of Tennessee while traveling? The highest level of benefits will be provided if you are away from home and require treatment for a life-threatening emergency. If your situation is urgent, yet not life-threatening, you should utilize the BlueCard Program. Phone (800) 810-Blue to locate a BlueCard Program provider. If you require medical services outside the United States, use BlueCard WorldWide participating providers by phoning the BlueCard Worldwide Service Center at (800) 810-2583 or collect at (804) 673-1177 if you are unable to find a suitable provider.