Name of Manual - Blue Cross and Blue Shield of Minnesota

Table of Contents
Chapter 5
Health Care Options
Member ID Cards/Health Coverage Options.......................................................................... 5-3
Fully Insured Groups .............................................................................................................5-3
Self-Insured Groups...............................................................................................................5-3
Member ID Cards ..................................................................................................................5-4
Member ID Card Conversion.................................................................................................5-4
Helpful Tips ...........................................................................................................................5-5
Verify Identity of Cardholder ................................................................................................5-5
Blue Cross and Blue Shield of Minnesota Coverage Options................................................ 5-6
Overview................................................................................................................................5-6
Aware Gold ® ..........................................................................................................................5-6
Aware Gold Limited ..............................................................................................................5-6
Aware PPO.............................................................................................................................5-6
Blue Selections....................................................................................................................... 5-7
Options Blue HRA/HSA........................................................................................................5-7
Comprehensive Major Medical..............................................................................................5-7
Double Gold...........................................................................................................................5-8
Freedom 1-2-3........................................................................................................................5-8
Simply Blue SM ........................................................................................................................5-8
Personal Blue SM .....................................................................................................................5-8
GoBlue ...................................................................................................................................5-8
InstaCare ................................................................................................................................5-8
Medicare Supplemental Plans................................................................................................5-9
Medicare Basic Blue ® ..........................................................................................................5-10
Extended Basic Blue ® ..........................................................................................................5-10
Senior Gold SM ......................................................................................................................5-11
Platinum Blue SM (Cost)........................................................................................................ 5-12
MedicareBlue PPO (Regional PPO) ....................................................................................5-13
MedicareBlue Rx (PDP) ......................................................................................................5-14
Guidelines for Determining Submissions to Medicare or Blue Cross.................................5-15
Inquiries and Claims Platinum Blue (Cost) .........................................................................5-15
Blue Plus Coverage Options.................................................................................................... 5-19
Comprehensive Plan ............................................................................................................ 5-19
Preferred Gold SM ..................................................................................................................5-19
Triple Gold...........................................................................................................................5-19
Medicare Select Product ......................................................................................................5-19
Minnesota Senior Health Options (MSHO) / Secure Blue (HMO) .....................................5-20
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (12/27/10) 5-1