Specialty Care for Medicare Plus Blue℠ PPO
All Medicare Plus Blue PPO members have direct access to health professionals for routine, preventive and specialty services. For most specialist services, individual members will have higher copays. The higher copay may also apply to group members.
If a member goes to a general care practitioner, their copay will not increase. Medicare Plus Blue PPO considers the following types of medical practice to be general care:
- General or family practice
- Internal medicine
- Obstetrics and gynecology
We also consider certified nurse practitioners and physician's assistants to be general care practitioners.
If a member needs help finding the right specialist in their network, there are a couple of ways you can help. You can log into web-DENIS to access the member’s benefit information or you can learn more on our benefit summaries page.
We encourage you to help members find in-network specialists. If you need help, please call our Provider Inquiry department at 1-866-309-1719.