Our PPO managed health care plans provide for the payment of benefits at a higher level of coverage when the member utilizes our network of preferred providers. These network providers, including physicians, specialty care providers, hospitals, and other health care facilities and practitioners, have contracted with Blue Cross and Blue Shield of Oklahoma (BCBSOK) to provide health care services at negotiated rates.
If the member elects to receive care from network providers:
- They will receive the higher level of benefits (in-network benefits)
- They are not required to file claim forms — network providers bill BCBSOK for services provided
- They are not balance billed — network providers will not bill for costs that are in excess of the BCBSOK allowable amount for covered services.
- Network providers are responsible for any necessary prior authorization
If the member elects to receive care from providers outside the network, they may choose:
The PPO plan is available to clients through the Blue Choice PPOSM network, one of the largest networks in Oklahoma. For health care services required outside Oklahoma, members have access to the BlueCard® national network of providers.
BCBSOK offers a variety of PPO plans with varying deductible, coinsurance and copay amount options.
All plans include an outpatient prescription drug benefit with either a three-tier or four-tier pharmacy copay design. Prescription drugs are available through retail pharmacies throughout Oklahoma and mail order pharmacy services.
For more detailed information on available benefit designs, a description of the services and supplies that are covered, a listing of those services and supplies that are limited or excluded, terms and general administration or for any questions you may have regarding our products and services, visit the Contact Us page to find the number of the regional sales office near you.