Blue Care

Individual Coverage

Our commitment to a healthier Mississippi begins with our commitment to you. Everything we do is designed to help you be healthy and stay healthy, all while managing healthcare costs. Partner with us and you'll understand why now, more than ever, it's good to be Blue.

So, what can Blue do for you?

When you have a health and wellness partnership with Blue Cross & Blue Shield of Mississippi, you get more than an insurance company. You get a team of people committed to helping you be as healthy as you can be, all while offering innovative health and wellness benefits unmatched anywhere else. See the information below for more details on Blue Care 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 Advantages

Blue Care Advantages

With options for calendar-year deductible, office visit co-pay and prescription drug co-pay, Blue Care 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.

Among the plan options are Blue Health Savings (high-deductible health) plans that feature a Health Savings Account (HSA). These options offer affordable coverage that gives you the ability to set aside tax-deductible HSA contributions and earn tax-free 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, 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 pre-certify the services for benefits to be provided. Our Health and Wellness Team will support our Network Providers in determining the medically-necessary services and if the services requested can be provided in Mississippi.

Centers of Excellence

Certain specialty services must be provided by a Center of Excellence Provider to receive the highest level of benefits. Blue Cross & Blue Shield of Mississippi has designated certain Network Providers as Centers of Excellence for services such as Hip and Knee Replacement, Spine Surgery and Cardiac Care.

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, non-emergency services performed at an emergency room will be subject to a higher co-pay.

Nurse Advice Line

As a Blue Care 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.

Blue Care Plan Options

Blue Care 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 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:

  • Co-Pay Option with Separate Medical and Rx Drug Deductible
    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.
  • Co-insurance Option with Combined Medical and Rx Drug Deductible
    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.
  • High Deductible Health Plan Co-insurance Option with Combined Medical and Rx Drug Deductibles (Blue Health Savings)
    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.

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.

Healthy You!

Healthy You!

Our Healthy You! wellness benefit helps you establish a good patient-provider relationship through annual wellness visits with a Mississippi Primary Care Network Provider at no out-of-pocket cost. The covered screenings and immunizations are age and gender-specific and help you "know your numbers" for blood pressure, cholesterol, blood sugar and weight. Once you know your health risks, you can work with your Network Provider to manage those risks through lifestyle changes and medication therapy with an emphasis on generic medications when appropriate. Click here to view a copy of our Healthy You! Wellness Guide including details on covered screenings and immunizations.

When health risks are identified early, illnesses can be managed and often prevented…and that's good for everyone.

be RxSmart Prescription Drug Benefit

be RxSmart Prescription Drug Benefit

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.

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 at a lower cost 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 Management

Blue Health Management

To help you be as healthy as possible, our Health and Wellness Team will work with the treating Network Provider to ensure the necessary care is provided in the most clinically-appropriate, cost-effective setting, to include our Centers of Excellence. Based on a person's health status, he or she may also qualify for one of our Blue Health Management enhanced benefit programs.

Our benefit plans also support you in establishing or making healthy lifestyle changes, such as tobacco cessation, eating healthy or beginning an exercise program. For information about tobacco cessation, tips on nutrition or to find a wellness center near you that will discount your membership if you are a Blue Cross & Blue Shield of Mississippi member, visit our "be healthy" section.

Health Savings Account

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:

  • Contributions made to HSAs are tax –deductible. The money withdrawn from HSAs to pay for qualified medical expenses is not subject to income tax – so individuals get income tax savings. Additionally, interest and investment earnings on HSA funds are tax-free.
  • Individuals can use Wells Fargo Visa® HSA debit cards to pay for eligible medical expenses, and the Wells Fargo Health Account ManagerSM portal makes it fast and easy to manage Wells Fargo HSAs anytime.
  • Saving for future medical expenses is also important. With a Wells Fargo HSA, participating members can choose to invest in a wide array of mutual funds to meet their saving goals. Plus, they can use their HSAs to complement their 401(k) or IRA retirement savings.

Learn more about Wells Fargo HSA by visiting www.wellsfargo.com/investing/hsa.

Customer Service Excellence Online & on the Phone

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

Optional Life Benefit

When you apply for Blue Care 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.