Medical Plan Descriptions

Plan

Contact

BlueCross BlueShield BlueChoice PPO

This open access plan features an extensive Oklahoma and national network of physicians and health care providers. Participants have access to any provider that is part of the network without the need to select a primary care physician when enrolling. Any specialist within the plan network can be seen without getting a referral from a primary care physician. The out-of-network benefit offers even more flexibility when selecting a provider. This plan also features a three-tiered pharmacy benefit with co-pays for generic, brand formulary and brand non-formulary prescriptions. The BlueChoice PPO plan does have a deductible and co-insurance amounts.

(888) 881-4648

www.bcbsok.com/OU/

BlueCrossBlueShielf BlueEdge HCA

The BlueEdge HCA is an employer-provided fund to pay for medical and prescription drug expenses and gives members control over how their medical care dollars are spent. At the start of the year, the University allocates a fund to help the participant pay for medical expenses covered by the plan. The fund is used to pay for eligible medical care expenses up to the fund amount. The first of $250 of preventive care, such as routine physicals and immunizations, is covered at 100% and is not counted against the member’s fund. Fund money left at the end of the year is added to the next year’s fund balance. This allows members to plan for future expenses as long as they remain in the plan. Although this plan has a lower monthly premium, it does have a higher deductible and higher out-of-pocket expenses and may be best suited for individuals without a large amount of medical expense.

As with the BlueChoice PPO plan, the BlueEdge HCA features an extensive Oklahoma and national network of physicians and health care providers. A primary care physician does not have to be selected. Any specialist within the plan network can be seen with a referral. The plan also has an out-of-network benefit, as well as a three-tiered pharmacy benefit for generic, brand formulary and brand non-formulary prescriptions.

(888) 881-4648

www.bcbsok.com/OU/

BlueCross BlueShield BlueLincs HMO

The BlueLincs HMO plan is a network medical plan that provides access to credentialed providers for low out-of-pocket expenses. Participants in this plan do not have deductibles but pay flat dollar amount co-pays for services. A primary care physician must be selected by those enrolling in the HMO plan, and referrals by the primary care physician are required. Authorization is required for all care outside of the primary care physician. The BlueLincs HMO plan has a limited network, and there is no out-of-network benefit, except in the case of a life-threatening emergency. This plan features a three-tiered pharmacy benefit with co-pays for generic, brand formulary and brand non-formulary prescriptions.

(800) 580-6202

www.bcbsok.com/OU/

Community Care HMO (Tulsa Area Only)

BlueLincs HMO includes many health providers in Tulsa. However, the BlueLincs HMO does not include Saint Francis Hospital, Saint Johns Medical Center, and their affiliated doctors. These hospitals and doctors are part of the Blue Cross Blue Shield BlueChoice PPO network.

Recognizing that many participants in the HMO plan use these hospitals and doctors, the university has also partnered with Community Care to offer an alternative HMO option that includes these facilities and doctors. For an HMO plan in Tulsa, you must choose between BlueLincs HMO or Community Care HMO.

The Community Care HMO plan is a network medical plan that provides access to credentialed providers for low out-of-pocket expenses in the Tulsa area only. Participants in this plan do not have deductibles but pay flat dollar amount co-pays for services. A primary care physician must be selected by those enrolling in the HMO plan, and referrals by the primary care physician are required. Authorization is required for all care outside of the primary care physician. The Community Care HMO plan has a limited network, and there is no out-of-network benefit, except in the case of a life-threatening emergency. This plan features a three-tiered pharmacy benefit with co-pays for generic, brand formulary and brand non-formulary prescriptions.

(800) 777-4890