Skip to main content

Individual & Family

Important Benefits Change

We’d like to highlight an important change to your policy.

Woman getting her blood pressure checked.

What Is Changing?

Non-emergency or non-urgent care out of state beyond the counties that border Oklahoma is not a covered benefit under your plan.

Coverage for non-emergency or non-urgent care outside Oklahoma and its surrounding border counties will be available only if the service is not available in your plan’s service area. If non-urgent or non-emergency care is not available in your plan’s service area, you may ask for a waiver to receive care outside Oklahoma and its border counties. You must have requested and received an approved waiver in advance of receiving care for your benefits to apply.

To find in-network care, log in to your member account or visit our Provider Finder® tool.

You need an approved out-of-service-area waiver from BCBSOK prior to receiving non-emergency or non-urgent care from any providers, whether in network or out of network, outside Oklahoma or the counties that border Oklahoma (also known as “contiguous counties”). Additionally, you need an approved out-of-service-area waiver from BCBSOK prior to receiving non-emergency or non-urgent care from out-of-network providers in counties that border Oklahoma.

To ask for a waiver for services, call Customer Service at the number on your member ID card.

Please refer to this page's Answers to Questions You May Have section to find what counties border (are contiguous to) Oklahoma and for additional information on out-of-service-area waivers and how to obtain a waiver. Once you receive your member contract for 2025, you may also refer to the “Out of State Services” section for further details on this benefit change.

Remember:

Out-of-state care beyond the border counties is not covered, unless you obtain an out-of-service area waiver. A waiver for otherwise covered services will be approved only if the services are not available in the plan’s service area. A waiver will be denied if adequate care is available in Oklahoma or its border counties. You may be redirected to available, local in-network services.

If you do not receive the appropriate waiver in advance, Blue Cross and Blue Shield of Oklahoma will not pay the claim.

As always, if you are facing a medical emergency call 911 or proceed to the nearest emergency room.

What Is Not Changing?

Stethoscope icon

Benefits

You can choose to go to an out-of-network provider or facility within Oklahoma without a waiver. If you do, however, you may pay more for your care than if you were to stay in network.

Hospital icon

Access to emergency & urgent care

You are able to get emergency and urgent care nationwide without the need for a waiver.

Doctor icon

Finding care

You can find in-network providers through your member account under Find Care.

Oklahoma icon

Freedom to choose

You can visit a range of in-network providers, specialists, and hospitals throughout Oklahoma and its border counties.

How to Request a Waiver

To request a waiver, call Customer Service at 1-866-520-2507. A Customer Advocate will need the following information, so it may be helpful to speak with your doctor ahead of calling:

  • Provider name, address and phone number
  • Provider type
  • Provider number/NPI (10-digits)
  • Provider tax ID (9-digits with a hyphen after the 2nd digit)
  • Diagnosis code
  • Estimated number of visits
  • First date of service

Answers to Questions You May Have

This information is only applicable to members of the identified Individual and Family plans.