Blue Care for Kids is a health and wellness benefit plan designed to help kids be healthy and stay healthy. With the peace of mind of comprehensive medical coverage, kids, with their parents and Network Provider, can focus on establishing healthy habits early in life. Best of all, Mississippi's health and wellness team is there to support kids and their parents along the way. That's why it's good to be a Blue Care kid! See the information below for more details on Blue Care for Kids benefit plans.
If you like what you see, click "Get Coverage Options" to see price and coverage options available for you. When you're ready, you can select a coverage option and start an application.
Blue Care for Kids Advantages
With options for calendaryear deductible, office visit co-pay and prescription drug co-pay, Blue Care for Kids allows you to select a benefit level that fits your health coverage needs while supporting you with the tools and information to make the most of your benefits, including making wise choices when it comes to managing your care and costs. Health savings account plans are also available with Blue Care for Kids.
Among the plan options are Blue Health Savings (highdeductible health) plans that feature a Health Savings Account (HSA). These options offer affordable coverage that gives you the ability to set aside taxdeductible HSA contributions and earn taxfree interest from investments, all while having the security of using the funds tax free when necessary for qualified medical expenses.Network Providers & Facilities
With Blue Care for Kids, you will have access to our comprehensive network of the highest-quality healthcare providers. Our Network Provider partnerships are based on a shared-focus of providing the highest quality of care while managing healthcare costs. Our members receive the highest level of benefits at a Network Provider including Network Physicians, Network Hospitals, Network Pharmacies and Network Allied Providers. Certain services are not covered when provided by a Non-Network Provider. For a complete listing of Network Providers, use the "Find a Network Provider" search tool.Out-of-State Network Providers
NOTE: Prior Authorization must be obtained by a Network Provider for non-emergent (non-emergency) elective services provided outside the State of Mississippi for services to be covered. If a Network Provider refers a member to a Network Provider located outside of Mississippi, the Provider must precertify the services for benefits to be provided. Our Health and Wellness Team will support our Network Providers in determining the medicallynecessary services and if the services requested can be provided in Mississippi.Emergency Services
In a medical emergency, it is important to seek emergency care whether you are in Mississippi or traveling outside the state. Our members have access to emergency services when and where they need them and benefits are provided at the network level. However, nonemergency services performed at an emergency room will be subject to a higher copay.Nurse Advice Line
As a Blue Care for Kids member, you will also have access to our Nurse Advice Line to help determine the best plan for care in non-emergency situations. You can call our Nurse Advice Line at 1-800-552-2134, and speak to a registered nurse 24 hours a day, seven days a week.Prescription Drug Benefits
As a Blue Care for Kids member, you will also have access to our industry, best-practice formulary. Search the formulary to see prescription drugs currently covered under the Blue Care for Kids Benefit Plan.
The presence of a prescription drug on the formulary is not a guarantee of coverage. All prescription drug coverage is subject to the terms of the applicable Health and Wellness Benefit Plan.
Blue Care for Kids Plan Options
If you're new to shopping for a benefit plan, you should consider several factors when selecting the plan that is right for you. Deductible, co-pay, co-insurance and out-of-pocket are some of the terms you will encounter as part of selecting a benefit plan.
The deductible is the amount paid by the member for medical services or prescription drugs before the benefit plan begins to pay. Plans may have separate or combined deductibles for medical and prescription drugs.
A co-pay, or co-payment, is the specified amount a member pays for a covered service, usually at the time the service is received.
Co-insurance is the member's share of the cost for certain covered services once the deductible is met.
Another important factor to consider when selecting your benefit plan is the out of pocket. "Out-of-pocket" refers to the money a member pays out of their own pocket when receiving medical care (i.e. visiting a doctor or filling a prescription) and includes deductibles, co-payments and co-insurance for covered services rendered by Network Providers. Each benefit plan has a limit on the total out-of-pocket costs a member pays in a benefit year. This is referred to as the out-of-pocket maximum. Non-network expenses do not accrue towards the out-of-pocket maximum.
While Blue Care for Kids offers you many options for calendar-year deductible, office visit co-pay and prescription drug co-pay, each of our benefit plans falls into one of the following plan structures:
These plans have separate medical and prescription drug deductibles that must be met before benefit plan payment begins. Deductibles do not apply where there is a co-pay amount, except in the case of category 2, 3 and 4 prescription drugs. Learn more about Blue Care Co-pay coverage with the sample Health and Wellness Benefit Plan and Summary of Benefits and Coverage below:
The medical and prescription drug deductibles are combined into one deductible for these plans. With these plans, a member will only have a co-pay for category 1 prescription drugs. For all other prescription drug categories and covered medical services, benefits will be provided based on the co-insurance amount outlined in the benefit plan. Learn more about Blue Care Co-pay coverage with the sample Health and Wellness Benefit Plan and Summary of Benefits and Coverage below:
The medical and prescription drug deductibles for these plans are combined into one deductible that must be met before co-insurance benefits will be provided for covered services. For all prescription drug categories and covered medical expenses, benefits will be provided after the combined deductible is satisfied, based on the co-insurance amount outlined in the benefit plan. Learn more about Blue Care Co-pay coverage with the sample Health and Wellness Benefit Plan and Summary of Benefits and Coverage below:
When viewing coverage options using our "Get Coverage Options" tool, you can learn more details about each plan by clicking the "Summary of Benefits" link located at the top right of each plan outline.
* DISCLAIMER: The Health and Wellness Benefit Plan and Summary of Benefits and Coverage are examples of the most popular benefit option and are not guarantees of coverage for a particular benefit. Following enrollment, covered members will be able to review their chosen benefit plan options on the myBlue Member portal.
Our Healthy You! wellness benefit helps a child establish a good patient-provider relationship through annual wellness visits with a Mississippi Primary Care Network Provider at no out-of-pocket cost. The benefit includes immunizations and screenings specifically designed for a kid's age and gender with the goal of helping kids be healthy and stay healthy.It's so important for kids to have a relationship with their Primary Care Provider. Healthy You! provides an annual wellness visit with a Mississippi-based Primary Care Healthy You! Network Provider with no out-of-pocket cost for covered services. The benefit includes immunizations and screenings specifically designed for a kid's age and gender with the goal of helping kids be healthy. Click here to view a copy of our Healthy You! Wellness Guide.
When health risks are identified early, illnesses can be managed and often prevented and that's good for everyone.
Our be RxSmart prescription drug benefits are based on an industry, best-practice formulary (drug listing) designed to help you make wise prescription drug choices through the use of generics and other low-cost alternatives to many brand name drugs. A drug must be listed on the formulary and purchased from a Network Community PLUS Pharmacy to be covered. Certain drugs require prior approval to be covered. We also provide enhanced drug searches and cost-savings tools through our secure myBlue member portal.
Please click here for a copy of Blue Cross & Blue Shield of Mississippi's Pharmacy Management Procedures.Prescription Drug Categories
With the be RxSmart prescription drug benefit, prescription drugs are grouped into categories to help members understand the most cost-effective options. Category 1 drugs have the lowest cost, and Category 4 drugs have the highest cost. When you choose category 1 drugs, you only have to pay the applicable co-pay amount because the prescription drug deductible does not apply to category 1 drugs. If you select a Blue Health Savings plan, however, the combined deductible must be met before co-insurance benefits will be provide for all prescription drug categories and covered medical expenses.Maintenance Drugs
Maintenance Drugs are prescribed for use on an ongoing basis. For these prescription drugs, members can receive a 90-day supply of maintenance drugs from one of our Community PLUS Maintenance Pharmacies.Community PLUS Network Pharmacies
Community PLUS Network Pharmacies are located throughout the state of Mississippi and across the country to give you the convenience of access to your prescription drugs at home and when you travel.
Blue Health ManagementJoin the Good Health Club!
Being healthy can be a lot of fun! You feel good and have lots of energy when you eat healthy and stay active. The Good Health Club promotes the 5-2-1-0 plan:
To help kids be as healthy as possible, our Health and Wellness Team will work with our Network Providers to ensure the necessary care is provided in the most clinically-appropriate, cost-effective setting, to include Centers of Excellence. Based on your health status, you may also qualify for one of our Blue Health Management enhanced health management programs which support kids and their parents in managing asthma or diabetes, for example.
Health Savings Account
Blue Health Savings members are eligible to open a Health Savings Account (HSA). With an HSA, you can contribute tax-deductible dollars toward future medical expenses including deductibles, co-payments, co-insurance and other qualified healthcare expenses, all while enjoying more affordable monthly premiums.
Blue Cross & Blue Shield of Mississippi has partnered with Wells Fargo to offer you HSA services. Advantages of a Wells Fargo Health Savings Account include:
Learn more about Wells Fargo HSA by visiting www.wellsfargo.com/investing/hsa.
Customer Service Excellence Online & on the Phone
Our Customer Service Team will be here to provide you the information and thoughtful answers you need every step of the way. You will also have access to a host of tools and information to help you make the most of your benefits.myBlue Online Portal
Our secure online myBlue member portal makes it easier than ever to access benefit information 24 hours a day, seven days a week. With myBlue, our members can view claims as they are filed, search for cost-effective prescription drugs and more. You will also begin your customized Journey to Wellness by completing the Blue Wellness profile via myBlue, which gives us a snapshot of your lifestyle and wellness status.
Members can stay connected on-the-go with our myBlue mobile app that includes a virtual ID card and the same great features as our myBlue web portal. The myBlue app is available for download today at no cost from the Apple App Store or Google Play.
Optional Life Benefit
When you apply for Blue Care for Kids health and wellness coverage, if you choose to also apply for Life coverage, you will be asked questions that will be used to determine your eligibility for optional Life coverage through Bluebonnet Life. Bluebonnet Life Insurance Company is an independent life insurance company.