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Health Insurance Marketplaces (Exchanges)

February 24, 2014

Here is some information about the Health Information Marketplaces, also known as Exchanges, that may be beneficial to you and your understanding of these plans.

  1. BlueEssentialsSM and MyChoice® Advantage members do not have out-of-networks benefits. To verify if you are in network or to locate an in-network provider for these members, please visit SouthCarolinaBlues (BlueEssentials prefixes ZCF, ZCU and ZCQ) or BlueChoiceSC (MyChoice Advantage prefixes ZCX and ZCJ) and use the Find a Doctor or Hospital tool. At each site, you can also view and access the provider directories for the appropriate plan.
  2. When you submit a precert (or authorization) request, please be sure to use the correct form. For a BlueEssentials member, use the BlueCross BlueShield of South Carolina form. For MyChoice Advantage, use the BlueChoice® HealthPlan of South Carolina form. Using the incorrect form may cause a delay in processing your request.
  3. BlueEssentials and MyChoice Advantage plans are individual policies. This means the parent's plan does not cover dependents. Covered individuals each have their own ID card. You must file claims under the ID number of the patient.
  4. The mother's policy does not cover newborn babies. As plans are individual policies only, the parent must get coverage for the newborn. You would then submit claims under the ID number of the newborn.

We will continue to provide you additional information as needed about the Exchange products. Please contact Provider Education for information about this bulletin at provider.education@bcbssc.com or toll free at 803-264-4730.

 

BlueChoice HealthPlan of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association. 

 

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