Discovering that your only available doctor is out of your insurance network can be stressful – especially when you need care urgently or live in an area with limited provider options. Out-of-network care often means higher costs, and in some cases, no coverage at all.
What does “Out-of-Network” mean?
Health insurance companies contract with specific providers – like doctors, hospitals, and labs – to create a network. These providers agree to negotiated rates, which keep costs lower for members. When you see an in-network provider, your costs are predictable and count toward your deductible and out-of-pocket maximum.
By contrast, out-of-network providers have no such agreement. They can charge higher rates, and your policy may cover only a portion of the bill. This often results in balance billing, where you pay the difference between what your insurer covers and what the provider charges. For example:
- An in-network office visit might cost $200, with your insurer paying $170 and you paying $30.
- The same visit out-of-network could cost $300, with your insurer still paying $170, leaving you to pay $130 extra.
But if you are an Arkansas Blue Cross and Blue Shield member with an eligible health plan, the BlueCard® program offers you some unique benefits that can make these situations easier to manage.
What is BlueCard®?
The BlueCard® program is a national program that allows traditional and PPO members to receive the same healthcare benefits and balance billing protection of their local Blue Plan when traveling or living outside of their plan’s area.
When a member of one Blue Cross and Blue Shield plan seeks care from a provider in another Blue Cross and Blue Shield plan’s area, the provider can submit claims to their local plan, which will forward the claims to the member’s home plan for processing.
Key Benefits of BlueCard®
- Nationwide Access: Connects you to more than 600,000 doctors and 6,000 hospitals across 48 states, plus providers in over 200 countries.
- Seamless Coverage: You receive in-network benefits when using participating providers anywhere in the country or abroad.
- Portable Benefits: Whether traveling or relocating, you can access care without switching plans.
- Simplified Claims: Providers submit claims through a single electronic network, reducing paperwork and delays.
- Emergency and Routine Care: From urgent needs to scheduled visits, BlueCard ensures continuity of care wherever you are.
How do I use the BlueCard® program?
To use the BlueCard program, members should:
- Always carry your most current Arkansas Blue Cross ID card.
- When you’re outside of Arkansas, pull out your ID card and call BlueCard access at 800-810-BLUE (2583) for information on the nearest Blue Cross and Blue Shield doctors and hospitals in the area where you are traveling or living.
- When you arrive at the doctor’s office or hospital, present your Arkansas Blue Cross ID card, and the doctor’s office or hospital will verify your membership and coverage.
- After you receive medical attention, your claims will be routed to Arkansas Blue Cross by the Blue plan in that area.
- All participating providers are paid directly, relieving you of any hassle or worry for covered benefits claims submission and processing. You usually will need to pay only for out-of-pocket expenses (non-covered services, deductibles, copayments or coinsurance).
Taking the next step
Taking charge of health insurance can feel overwhelming, but with the right guidance, your child can find a plan that works for them. Our team is ready to help you get the InsideTrack to finding the right health insurance plan. To learn about your options, you can speak with our team by calling 800-392-2583, visiting our member portal or scheduling an appointment at your nearest ArkansasBlue Welcome Center. Select the link to learn more about the BlueCard® program.