PacificSource, Blue Cross Blue Shield, and Allegiance are the medical plan claims administrators. The plans provide the same benefits but have differences in provider networks.
How The Plan Works:
The benefits of these plans depend on the health care provider the member uses. When an in-network provider is used, in-network benefits apply. When an out-of-network provider is used, out-of-network benefits apply.
Major Plan Differences
The major differences in the medical plans are the participating providers. Check which providers participate on the medical plan claims administrator’s websites see the back of the Choices active and retiree workbooks.
- PacificSource Medical Plan (www.PacificSource.com/MUS).
- Blue Cross Ble Shield Medical Plan (www.bcbsmt.com).
- Allegiance Medical Plan (www.abpmtpa.com/mus).
- Emergency services are covered everywhere. However, out-of-network providers may balance bill the difference between the allowed amount and the charge.
- Members may self-refer to any Primary Care Provider or Specialist.
Note: The Medical Plans cover the same services and have:
Network Providers – Providers who have contracted with the medical plan claims administrator’s to manage and deliver care for Plan members and who accept the allowed amount as payment in full. Members will pay less out of pocket expenses if they see an In-Network provider.
Out-of-Network Providers – Providers who have not contracted with the medical plan claims administrators and
who may balance bill the difference between their charge and the allowed amount.
Members will pay more out of pocket expenses if they see an Out-of-Network provider.