Houston Texas Plan Participation Agreement between Blue Cross Blue Shield Assoc. and Blue Cross Blue Shield of MO regarding healthcare benefit provisions

• Category: Corporations - Public - Participation
• State: Multi-State
• City: Houston
• Control #: US-EG-9383
• Format: Word; Rich Text

Description

Plan Participation Agreement between Blue Cross and Blue Shield Association and Blue Cross and Blue Shield of Missouri regarding health care benefit provisions (Federal Employee Program) dated January 1, 1995. 13 pages. Houston, Texas Plan Participation Agreement between Blue Cross Blue Shield Association and Blue Cross Blue Shield of Missouri is a comprehensive healthcare benefit provision agreement. This agreement covers various types of healthcare plans and provisions for individuals residing in Houston, Texas. One of the types of participation agreements is the "Preferred Provider Organization" (PPO) plan. Under this agreement, Blue Cross Blue Shield Association and Blue Cross Blue Shield of Missouri have formed a network of doctors, hospitals, and healthcare providers in Houston, Texas, who have agreed to provide services at discounted rates to plan participants. The PPO plan allows participants to choose their healthcare providers without requiring a referral and provides coverage for both in-network and out-of-network services. Participants can receive benefits for a wide range of medical services, including preventive care, hospital stays, prescription medications, and specialty care. Another type of participation agreement is the "Health Maintenance Organization" (HMO) plan. This agreement establishes a network of healthcare providers in Houston, Texas, that have a contract with Blue Cross Blue Shield Association and Blue Cross Blue Shield of Missouri. Participants in the HMO plan must select a primary care physician (PCP) within the network who will coordinate their healthcare needs and provide referrals for specialized care. The HMO plan emphasizes preventive care and typically requires participants to obtain services within the network, with limited coverage for out-of-network providers. Additionally, the agreement may include provisions for "Exclusive Provider Organization" (EPO) plans. EPO plans combine elements of both PPO and HMO plans. Participants in the EPO plan have access to a network of healthcare providers, like in the HMO plan, but do not require a PCP or referrals for specialized care. However, similar to the HMO plan, EPO plans typically do not provide coverage for out-of-network services. Houston, Texas Plan Participation Agreement between Blue Cross Blue Shield Association and Blue Cross Blue Shield of Missouri outlines the specific provisions, terms, and conditions for each type of plan mentioned above. It covers details such as cost-sharing responsibilities, coverage limits, network provider directories, claims procedures, and customer service contacts. This agreement aims to ensure that Houston residents have access to quality healthcare services while providing transparency and clarity regarding their healthcare benefits.

Houston, Texas Plan Participation Agreement between Blue Cross Blue Shield Association and Blue Cross Blue Shield of Missouri is a comprehensive healthcare benefit provision agreement. This agreement covers various types of healthcare plans and provisions for individuals residing in Houston, Texas. One of the types of participation agreements is the "Preferred Provider Organization" (PPO) plan. Under this agreement, Blue Cross Blue Shield Association and Blue Cross Blue Shield of Missouri have formed a network of doctors, hospitals, and healthcare providers in Houston, Texas, who have agreed to provide services at discounted rates to plan participants. The PPO plan allows participants to choose their healthcare providers without requiring a referral and provides coverage for both in-network and out-of-network services. Participants can receive benefits for a wide range of medical services, including preventive care, hospital stays, prescription medications, and specialty care. Another type of participation agreement is the "Health Maintenance Organization" (HMO) plan. This agreement establishes a network of healthcare providers in Houston, Texas, that have a contract with Blue Cross Blue Shield Association and Blue Cross Blue Shield of Missouri. Participants in the HMO plan must select a primary care physician (PCP) within the network who will coordinate their healthcare needs and provide referrals for specialized care. The HMO plan emphasizes preventive care and typically requires participants to obtain services within the network, with limited coverage for out-of-network providers. Additionally, the agreement may include provisions for "Exclusive Provider Organization" (EPO) plans. EPO plans combine elements of both PPO and HMO plans. Participants in the EPO plan have access to a network of healthcare providers, like in the HMO plan, but do not require a PCP or referrals for specialized care. However, similar to the HMO plan, EPO plans typically do not provide coverage for out-of-network services. Houston, Texas Plan Participation Agreement between Blue Cross Blue Shield Association and Blue Cross Blue Shield of Missouri outlines the specific provisions, terms, and conditions for each type of plan mentioned above. It covers details such as cost-sharing responsibilities, coverage limits, network provider directories, claims procedures, and customer service contacts. This agreement aims to ensure that Houston residents have access to quality healthcare services while providing transparency and clarity regarding their healthcare benefits.