Margie Keener - Authorized Agent BlueCross BlueShield of GA

What is Blue Value Select and Blue Value? We offer both the comprehensive Blue Value Select Plan and the limited, high deductible Blue Value Plan. Both plans allow you to utilize our PPO network that includes over 10,000 physicians and over 120 hospitals in Georgia. You can utilize the Tennessee network if you use Doctors and Hospitals in Tennessee. Blue Value Select PPO Features: *$30 copay Doctor and Specialist - unlimited visits on all Select options in network (this includes x-ray and lab work when performed and billed in the physician's office) *30 copay for Preventive Care in network (this includes mammograms & PAP tests for women, prostate screenings for men) *Prescription Drug coverage with a $15/$30/$45 copay after $200 annual deductible ($15 Generic, $30 Brand, $45 Non Formulary) *150 Emergency Room Copay for medical emergency or serious accident *80% coverage in-network for Hospitalization and Surgical procedures after deductible *Maternity coverage available at 80% after deductible on FAMILY CONTRACTS ONLY. Blue Value Plan Features: *$40 office visit co-payment for the first 6 visits per year for illness only with No Deductible (includes x-ray/lab work when performed & billed in physician's office) After 6 visits Plan pays 70% in-network after deductible is met *70% coverage for preventive care, limited to $250 per year with NO deductible. *Prescription Drug Coverage with a $15/$30/$45 copay after deductible ($15 Generic, $30 Brand, $45 Non-Formulary - deductible varies by plan selected) *$150 Emergency Room co-payment for medical emergency or serious accident *70% coverage in-network for Hospitalization and Surgical procedures after deductible. *Maternity coverage available on PPO $1000 & $2000 FAMILY CONTRACT ONLY. Please refer to plans at Quotes and or Applications Link. A full disclosure of all benefits, exclusions and limitations is included in the Contract for this coverage.

1. WHAT IS A PPO PLAN? PPO stands for Preferred Provider Organization. You do have a network of doctors to use and if you stay in the network, you have better benefits. It does allow you to use doctors that are not in the network but your benefits are reduced (example: your plan may pay 80% if you are in-network and 60% if you are out-of-network). 2.WHAT IS A DEDUCTIBLE? The deductible is what you pay out of your pocket before your insurance plan starts to pay. 3.WHAT IS A COPAY? A copay is a set dollar amount that you pay at your doctor's office, for a prescription drug, for an emergency room visit, etc. and the insurance will pay the balance for you. No deductible is required to be met in most cases. 4. WHAT IS A PRE-EXISTING CONDITION? Pre-existing conditions are defined as health problems you have had or been treated for in the past twelve months and those conditions would not be covered until you have had coverage for twelve months. 5. WHAT IS COINSURANCE? Coinsurance is the percentage paid by your insurance plan and the percentage you pay up to your calendar year out-of-pocket maximum (example: plan pays 80%- you pay 20%). You usually have to meet a deductible before your coinsurance starts. 6. IF I HAVE A PPO PLAN AND I AM OUT OF STATE, CAN I STILL BE IN THE NETWORK AND PAY A COPAY TO A DOCTOR? Yes, with BCBSGA, you have the opportunity to be out of state and still have in-network benefits. When outside Georgia, call 1-800-810-BLUE to find the nearest network provider. Then show your member ID card to the provider. If you didn't call and used a doctor that was out of network, you still have coverage but at a reduced benefit.