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- Urgent Care Center $35 copay Prescription Drugs Preferred Retail Pharmacy. This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. Before making a final decision, please read the Plan’s federal brochure (RI 71-005). All benefits are subject to the definitions, limitations, and exclusions set forth in the.
2020-06-02 Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is waiving all copays for in-network primary care and outpatient behavioral health visits for Medicare Advantage members from June 1 through the end of 2020. Visits do not have to be related to COVID-19 and can be done in person or virtually through telehealth.
| Basic Option | |
|---|---|
| Preventive Care | Nothing for covered preventive screenings, immunizations and services |
| Physician Care | $30 for primary care1 |
| Virtual doctor visits by Teladoc® | $0 for first 2 visits |
| Urgent Care Center | $35 copay |
| Prescription Drugs | Preferred Retail Pharmacy: Tier 1 (Generics): $10 copay Tier 2 (Preferred brand): $55 copay2 Tier 3 (Non-preferred brand): 60% of our allowance ($75 minimum)2 Tier 4 (Preferred specialty): $65 copay2 Tier 5 (Non-preferred specialty): $90 copay2 Mail Service Pharmacy: Available to members with Medicare Part B primary only. Visit the Medicare page for more information. Tier 1 (Generics): $20 Tier 2 (Preferred brand): $100 copay Tier 3 (Non-preferred brand): $125 copay Specialty Pharmacy: Tier 4 (Preferred specialty): $85 copay2 Tier 5 (Non-preferred specialty): $110 copay2 |
| Maternity Care | $175 inpatient $0 outpatient |
| Hospital Care | Inpatient (Precertification is required): $175 per day; up to $875 per admission Outpatient: $100 per day per facility1 |
| Surgery | $150 in an office setting1 $200 in a non-office setting1 |
| ER (accidental injury) | $175 per day per facility |
| ER (medical emergency) | $175 per day per facility |
| Lab work (such as blood tests) | $0 copay1 |
| Diagnostic services (such as sleep studies, CT scans) | Up to $100 in an office1 Up to $150 in a hospital1 |
| Chiropractic Care | $30 per treatment; up to 20 visits per year |
| Dental Care | $30 copay per evaluation; up to 2 per year |
| Rewards Program | Earn $50 for completing the Blue Health Assessment3 Earn up to $120 for completing three eligible Online Health Coach goals3 |
What Is The Copay For Urgent Care With Blue Cross Blue Shield
Sometimes it's easy to know when you should go to an emergency room (ER), such as when you have severe chest pain or unstoppable bleeding. At other times, it's less clear. Where do you go when you have a sprained ankle or an ear infection? The ER is always an option, but it can be an expensive one.
What's more, as a growing number of people use ERs to treat minor illnesses, wait times for non-life threatening conditions are increasing. If you are not severely ill or injured, you will likely spend more time waiting in an ER than if you visit an urgent care center or other health care provider.
When considering your time, money and – especially – your health, it's important to know your options. The good news is that you have choices for receiving in-network care that work with your schedule and give you access to the kind of care you need. Know when to use each for non-emergency treatment and when it's necessary to go to the ER.
Doctor's Office
Your doctor's office is generally the best place to go for non-emergency care such as health exams, colds, flu, sore throats and minor injuries. Seeking treatment from your doctor will often result in lower out-of-pocket costs than either an urgent care facility or an ER.
Is Urgent Care Covered By Blue Cross Blue Shield
Your doctor's office may take walk-ins, but it's best to call ahead to see if this option is available. You may need to make an appointment.
If you have an HMO, you should visit your primary care physician (PCP). Your PCP can provide non-emergency treatment or refer you to a specialist if your medical condition requires specialized treatment. If you do not have a PCP, call the number on the back of your member ID card or use Provider Finder® to search for a doctor within your plan's network
Blue Cross Blue Shield Prescription Formulary
.Retail Health Clinic
Walk-in clinics are often located in stores and pharmacies and provide convenient, low-cost treatment for minor medical problems like: ear infections, athlete's foot, bronchitis and some vaccinations. Their hours are similar to retail store hours, and their out-of-pocket costs are generally lower than an urgent care facility or an ER. Walk-in clinics are a great option for non-emergencies if you do not have a doctor or cannot get in to see your doctor on a timely basis.
Urgent Care Facility
Urgent care centers can provide care when your doctor is not available and you don't have a true emergency, but need immediate care. For example, they can treat sprained ankles, fevers, and minor cuts and injuries. These are illnesses or injuries that do not pose an immediate threat to your health or life.
Blue Cross Blue Shield Medication Formulary
Urgent care centers are often open on evenings, weekends and holidays. Medical services at an urgent care facility typically have lower out-of-pocket costs than an ER but may be higher than if you visit a doctor's office or a retail health clinic.
Emergency Room
Your local ER is available 24 hours a day, seven days a week and can treat serious illnesses and injuries. For medical emergencies, call 911 first. You may need an ambulance if:
Blue Cross Blue Shield Urgent Care Copay 2020 Online
- You need to be moved by medical professionals to prevent further injury
- Your condition is life-threatening or you think it may be life-threatening
- The distance to the hospital would cause a significant delay in receiving immediately-needed medical assistance
How Much Is Urgent Care Visit Blue Cross Blue Shield
In the event of an emergency, it's important to get care at the hospital closest to you. You don't need to get prior approval if the ER closest to you is out-of-network. In many cases, you won't be charged more for these services than you would at an in-network ER.
If you're ready to search for a doctor, retail health clinic, urgent care center, or hospital, visit Provider Finder® and select your plan's network.