The BlueCard® Program Sample Clauses

The BlueCard® Program clause defines the terms under which insured members can access healthcare services when traveling or living outside their home plan’s service area, but within the Blue Cross and Blue Shield network. It typically outlines how claims are processed, how members can locate participating providers, and how benefits are coordinated across different regional Blue Cross and Blue Shield entities. This clause ensures that members receive consistent coverage and streamlined claims processing nationwide, solving the problem of limited access to care and administrative confusion when members are away from their primary coverage area.
The BlueCard® Program. Under the BlueCard Program, when Members access covered health care services in a geographic area served by a Host Plan, Blue Cross and Blue Shield will remain responsible for fulfilling the obligations of this Agreement. The Host Plan will be responsible for providing such services as contracting with its participating providers and handling substantially all interactions with its participating providers and, as applicable, providing some managed care services.
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