January/Feburary 2008

NEW!  GoBlue Health Services Card ready for launch

In February, Blue Cross and Blue Shield of Florida, Inc. (BCBSF) will launch its new limited benefit product line for the individual under-65 market.  Simple, practical and affordable, the GoBlue Health Services Card targets the working uninsured in Florida, providing inexpensive health coverage to them and their families.

One in four Florida residents younger than age 65 is uninsured, according to a report recently released by the Florida Health Insurance Advisory Board.*  GoBlue provides access to medical services for individuals who may not have had coverage in the past or may not be able to afford comprehensive insurance. The product is targeted toward the working uninsured and early retirees with annual household incomes between $25,000 and $50,000; and families with children at a slightly higher income level. GoBlue offers complementary coverage for those who currently only have catastrophic coverage, such as a BCBSF Hospital/Surgical product, with a combined premium less than that of a comprehensive plan.

GoBlue costs between $18 and $59 per member, per month, based on age. The plans are non-medically underwritten and provide indemnity-type payments toward physician office services, lab work, preventive and basic dental services and prescriptions.

BCBSF soft launched GoBlue in November 2007 in advance of the official February debut, to test market the product.  A new consumer sales website designed specifically for GoBlue includes scenarios that illustrate how the health insurance could work for them and the type of savings a GoBlue member may experience when compared to being uninsured. Click on the links below to see examples of how your patients might use their GoBlue benefits during a typical six-month period.  A Spanish version of the GoBlue website will launch in January. 

Jim, Maria & Nikki

Luisa and Baby Miguel

Marcus

Sam and Ellen

Coverage

The GoBlue health services card provides limited benefits for basic and preventive care. With GoBlue, members get the best value when receiving services from NetworkBlue providers. They are also protected from balance billing when they use BCBSF’s Traditional Network. Physicians and providers who participate in NetworkBlue or our Traditional Network can bill for no more than the allowed amount for covered services. 

Please note that initial communication sent to physicians and providers regarding GoBlue incorrectly stated, “For services not covered by GoBlue, members have access to network rates.”   Members do NOT have access to network rates for non-covered services under GoBlue.  However, GoBlue members do have access to the Physician Discount program for non-covered services rendered by NetworkBlue providers that participate in that program.

The coverage provided by GoBlue is not comprehensive and does not include coverage for services such as hospitalization, emergency room visits, routine maternity care, mental health and substance dependency care and treatment, rehabilitative therapy or spinal manipulations. There is no coordination of benefits with GoBlue, so it will always pay as primary. As with all BCBSF plans, GoBlue offers care support and wellness programs to members, including the BlueComplements® health-related discount program. There are two GoBlue plans to choose from:  Plan 90 and Plan 91.

Plan Benefits

  • GoBlue provides limited coverage in a physician office, urgent care center, convenient care centers, and independent clinical lab.

  • Services such as sick visits, allergy testing and injections, surgery in the office, and preventive care for adults and children are covered when rendered in these locations.

  • Diagnostic imaging is covered in these locations as well, with exceptions mandated by law:

    • mammograms and screening for osteoporosis are both covered at an independent diagnostic testing facility (IDTF) or outpatient hospital setting.

  • GoBlue pays up to $50 per provider per date of service for covered services in these locations.

  • Members pay the difference between the BCBSF payment and the allowed amount.

  • Members pay nothing for covered lab services at Quest Diagnostics, Inc.

  • Payment for out-of-network independent laboratory services is limited to $50 and the member is responsible for the balance.

Pharmacy benefits

GoBlue provides limited coverage for prescription drugs and diabetic supplies at a retail pharmacy. Contraceptives and self-injectable drugs are not covered. GoBlue pays up to $5 or $15 per prescription, depending on the plan purchased.

Dental benefits

GoBlue also provides limited coverage for dental services. GoBlue pays up to $50 per dentist per date of service for preventive dental services; and basic services (plan 91 only).

Identifying membersGo Blue Card

Members receive a magnetic stripe identification (ID) card. GoBlue is clearly identified in the upper right corner and the card indicates it’s “A limited benefits plan.” To confirm GoBlue member benefits, submit an Eligibility and Benefits transaction through the Availity®1 Health Information Network. If your office is equipped with a card reader compatible with Availity’s card processing program, you can simply swipe the GoBlue card to access real-time benefits information.

Calculating member responsibility

GoBlue pays up to $50 per provider per date of service for covered services. Members pay the difference between the BCBSF payment and the allowed amount. You can use CareCalc, accessed through the Availity Eligibility and Benefits Inquiry, to determine the member’s responsibility at the time of service. Enter the member’s diagnosis and treatment (procedure) codes into the Member Responsibility Calculation screen. CareCalc responses are based on member benefits and provider contractual allowances at the time of inquiry.

Claims submission

Submit GoBlue claims electronically through the Availity®1 Health Information Network. For paper claims, mail to BCBSF at: P. O. Box 1798 , Jacksonville , FL 32231.

Additional Information

For more information on GoBlue, call the Provider Contact Center at (800) 727-2227.

*Miami Herald, Nov. 1, 2007

1 Availity, L.L.C., is an independent company formed as a joint venture between Navigy, Inc., a wholly owned subsidiary of Blue Cross and Blue Shield of Florida, Inc., Health Care Service Corporation, and HUM-e-FL, Inc., a subsidiary of Humana, Inc. Blue Cross and Blue Shield of Florida has business arrangements with Availity with the goal of reducing costs in the Florida health care marketplace, simplifying provider workflow, improving patient experience and in providing HIPAA-AS compliant solutions. For more information or to register, visit Availity’s website at www.availity.com.