Getting to know Group Care (2023)

Group Care is a comprehensive health plan offered statewide, with extensive coverage for your peace of mind.

Group Care plan = Preferred Care PPO network
ID card
1

MEMBER NAME

- Your name will appear here.

2

MEMBER ID NUMBER

- Used to identify you so your provider knows how to bill your health plan.

3

PHARMACY COVERAGE

- This is where you will find Plan Description and ID Numbers relating to your Pharmacy Coverage.

4

PLAN TYPE

- What type of network your plan has and which providers you can see who are "in-network."


KNOW YOUR COVERAGE

Essential Health Benefits

Your plan covers a variety of benefits to keep you healthy. They include:
Ambulatory (outpatient) services Emergency care services Hospital benefits Maternity and newborn care Pharmacy and prescription drugs Contraceptive coverage Coverage for clinical trials Rehabilitative and habilitative services Laboratory services Preventive and wellness services and chronic disease management Vision and dental benefits for your children Mental health and substance use disorder services

 

Certain limitations and exclusions apply to Essential Health Benefits

Schedule of Benefits

Your Schedule of Benefits (SOB) includes information about what services are covered, what's not covered and how much it will cost.
Example of Schedule of Benefits document
1

IN-NETWORK

providers have agreed to accept a contracted (discounted) rate for your care. You'll save money by visiting a doctor or hospital in your network.
2

OUT-OF-NETWORK 

providers can charge more, which means you'll pay more when you visit an out-of-network doctor or hospital.
3

COMPARISON

Shows a breakdown of what you can expect to pay for specific services if you choose to visit a doctor that is in your network versus one that is outside your network.

Prescription Drug Coverage

You can manage your prescription drug coverage by logging in at bcbsla.com/myaccount and choosing "Pharmacy" on the dark blue bar near the top of the page. Once you log in, you can:
See your drug claims Price a drug See your drug benefits Learn about your medicine Find a pharmacy File a drug claim
You can also view covered drug lists, search for drugs and find out how to save on drugs at bcbsla.com/rx.


MANAGE YOUR COST

Stay in Your Network

Control costs by staying in your network. Your plan includes both in-network and out-of-network coverage, but you will pay more when you visit an out-of-network doctor or hospital.

Be proactive about staying in your network by visiting bcbsla.com/findcare to find a doctor or hospital in your network.

Group Care plan = Preferred Care PPO network

Get Care in the Right Place

Save time and money by getting the right care in the right place. Don't go to the emergency room for a cold.

Primary Care

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BlueCare Telehealth

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Urgent Care

satchel with three dollar signs

$$$

Emergency Room

ambulance icon with three dollar signs

$$$$

Choose the Right Care

BENEFIT FROM CONVENIENCE

Your Online Account

Activate your Blue Cross online account quickly and easily. Once you're registered, you can manage your account, choose to go paperless, review your benefits, see your claims status, view your digital ID card, and more - 24 hours a day, seven days a week.
Image of laptop
Learn How to Set Up Your AccountActivate Your Account

BlueCare Telehealth: Get Care from Anywhere!

Medical and behavioral health visits available.

Have a BlueCare online medical visit 24/7 or behavioral health visit by appointment using a computer, smartphone, tablet or any device with internet and a camera. Before every visit, you will see what it will cost based on your plan type and benefits. You will not be charged until the visit is complete. All providers are U.S. trained and board certified.

BlueCare is

24/7

for medical visits
BlueCare is

Faster

than going to urgent care
BlueCare costs

Less

than the ER

Visit www.BlueCareLA.com or download the BlueCare (one word) mobile app on your Apple or Android device.
BlueCare logo
Download on the Apple StoreGet it on Google Play  

Explanation of Benefits

After each visit to a doctor or hospital, we will send you an Explanation of Benefits (EOB). It is a summary of the charges for the care or services you received. It shows what we cover and what the provider charged or what the service cost. It is not a bill. You may choose to go paperless and get your EOBs online by logging in at bcbsla.com/myaccount and choosing "Account Preferences."
Image of example Explanation of Benefits
1

AMOUNT CHARGED

What the doctor, clinic or hospital charged for care.
2

PLAN(S) DISCOUNTS & PAYMENTS

This is your discount on care costs or what your plan paid for care.
3

YOUR RESPONSIBILITY

This is what you must pay for care before your health coverage begins to pay for the parts of your care that are not covered by your plan.
4

AMOUNT YOU MAY OWE

This is the part of your claims you may have to pay out of pocket.
Go to EOB

What Should You Do After Enrollment?

Congratulations! You've got health insurance. But now what do you do? Don't worry, we've got answers!

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