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About the EPO plan...
The EPO (Exclusive Provider Organization) plan delivers in-network-only benefits through the national
BlueCard® PPO network. Our BlueCard PPO network links participating
doctors and hospitals to Blue Cross and Blue Shield Plans throughout the United States, providing a
nationwide network of doctors, hospitals, and other health care professionals. More than 600,000 physicians
and over 6,000 hospitals participate in the network, the largest health care network in the nation.
EPO members must seek care from participating BlueCard PPO providers, except in the case of a life- or
limb-threatening emergency. If care is received from a nonparticipating provider, there is no benefit
coverage. It is the member's responsibility to confirm that the providers and specialists they are seeing
participate in the network. Claims will not be paid if care is received from a provider who is not in the
network.
No PCP or Referral Needed
With the EPO plan, members do not need to select a Primary Care Physician (PCP), and referrals are not needed to
access specialty care. Members can access any network doctor or hospital at any time and enjoy the
in-network level of benefits. Care must be received from participating BlueCard PPO providers, except in the case of a life- or limb-threatening emergency.
Easy Service No Hassles
When using BlueCard PPO doctors and hospitals, members have no claim forms to file and virtually no
paperwork. All BlueCard PPO providers will handle all of the paperwork for them. Plus, Horizon BCBSNJ
offers toll-free customer service Monday through Friday, 8 a.m. to 8 p.m., Eastern Standard Time, so
members can get the help they need when it's convenient for them. Members also have access to our
interactive Member Web site, where they can look up claim status and enjoy other online services designed
to make their health care experience more satisfying.
How to Locate a BlueCard PPO Provider for Your EPO Coverage
Members can access BlueCard PPO network doctors and hospitals several ways. Using the functionality of this
Web site, members can access information about network providers, including directions to their locations.
Click here to access the BlueCard Physician Finder. Members can also call the BlueCard Access Line at
1-800-810-BLUE (2583) to access participating PPO providers. If you are not yet an enrolled member,
indicate that you are not yet enrolled but are considering becoming a member.
Portable Benefits Coverage
So, whether traveling (business or vacation) or living in another state (student away at college), members
can take advantage of their benefits by presenting their ID cards to any participating doctor or hospital.
Once enrolled, members simply carry our easily identifiable ID cards with a PPO in a suitcase logo,
which lists a toll-free number to help reach a BlueCard PPO provider.
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