PCP Coordinated Care HMO plan updates for 2021
PCP Coordinated Care HMO plan updates for 2021

PCP Coordinated Care HMO plan updates for 2021

Our PCP Coordinated Care HMO benefit plans offer Blue Cross® Blue Shield® of Arizona (BCBSAZ) members supported healthcare and reduced costs. The plans are available to individuals and families, as well as employer groups. Although the referral and precertification requirements remain unchanged, we’ve made a few updates for the 2021 individual/family plans. Here are the highlights.

Expansion of the MaricopaFocus and PimaFocus networks for individual/family plans

The MaricopaFocus Network now includes the hospitals/facilities and providers affiliated with Abrazo Health, along with those affiliated with Dignity Health and Phoenix Children’s Hospital. We’re continuing to partner with Equality Health to enhance value-based care for our members with individual/family PCP Coordinated Care HMO plans in Maricopa County.

The PimaFocus Network now includes all of the Carondelet hospitals and the other Tenet Healthcare facilities and provider groups located in Pima County, along with facilities and provider groups affiliated with Tucson Medical Center.

Networks and prefixes for PCP Coordinated Care HMO plans

Benefit updates for individual/family plans

  • PCP visits at no charge to the member (visit for preventive care counts toward the limit if the limit has not yet been met):
    • AdvanceHealth plans now include the first four visits at $0 cost share
    • SimpleHealth plans continue to include the first three visits at $0 cost share
    • EverydayHealth plans continue to include the first two visits at $0 cost share
    • All TrueHealth plans now include unlimited free visits to the designated PCP
  • For EverydayHealth and TrueHealth plans only, the deductible is waived for the outpatient surgery facility fee at ambulatory surgery centers
  • BlueCare AnywhereSM 24/7 telehealth benefit now includes counseling and psychiatric care, along with medical services: all plans (group plans also have this benefit)

Note: Coverage of all services depends on member eligibility and medical necessity requirements.

New ID card design for individual/family plans

The member ID card displays one of the prefixes listed above and clearly indicates the designated PCPs for each family member on the front of the card. Below is a sample:

More information
For detailed information about our PCP Coordinated Care HMO plans, including helpful resources and tools, see the PCP Coordinated Care HMO Plans – Provider Guide, or download the e-learning module (great for office staff training). These and other resources are available in the secure provider portal through the “Practice Management” and “Education & Training” menus.

If you have questions, please contact your provider liaison or call Provider Partnerships at 602-864-4231 or 1-800-232-2345, ext. 4231.

Equality Health is a separate, independent company that provides services to BCBSAZ providers and members.

BlueCare Anywhere is a service mark of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.

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Our members can take a digital ID card with them wherever they go with the MyBlue AZSM mobile app.