What You Need to Know About Our ACA Plans

Learn more about the medical, dental and prescription services in your health plan.

• Learn the difference between in-network and out-of-network benefits
• Find a pharmacy to fill a prescription
• Discover more about Blue Dental^SM networks

What you need to know to submit a claim for medical or dental care.

• How to submit a claim
• How to submit a dental claim
  

Get information on grace periods and what they mean for pending claims.

• How late or missed payments can impact your coverage

Learn more about retroactive denials and what you can do to avoid them.

• Understand retroactive denials and why they happen

• How Blue Cross handles overpayments by members

Understand more about prior authorization and when you may need it. 

• Services that require prior authorization
• Understand when you need prior authorization for a prescription drug

Learn how to request prescription drugs your plan doesn't cover. 

• How to request a review for prescription drug coverage
• Where to find a PPO Coverage Request Form
• Where to find an HMO Prior Authorization Callback Form
• Request an external review for approval of a drug

Understand how to use the information in your explanation of benefits.

• Understanding your explanation of benefits statement

How to coordinate multiple benefit plans to pay for services.

• Learn more about coordination of benefits