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March 2014

Blues provider networks for individual market products explained

To help you understand which provider networks are being used for the new Blue Cross individual market plans offered by Blue Cross Blue Shield of Michigan and Blue Care Network, here’s a list of the plans and the corresponding network:

  • Blue Cross® Premier plans use the current BCBSM TRUST PPO network.
  • Blue Cross® Preferred plans use the current BCN HMO network.
  • Blue Cross® Select plans use the current BCN PCP Focus network.**
  • Blue Cross® Partnered plans use the Blue Cross Partnered network that primarily consists of physicians associated with Mercy Health (available only to residents of Kent, Muskegon and Oceana counties).

**The PCP Focus network expanded from seven to 21 Michigan counties for group plans and is available in 19 Michigan counties for the 2014 Blue Cross Select individual market plans.

Your participation in the Blues provider networks has not changed from 2013 unless:

  • You requested a change
  • You were added to the new Blue Cross Partnered network (for residents of Kent, Muskegon and Oceana counties)
  • Your status with the PCP Focus network changed as part of that network’s review and expansion.

To find more information:

  • Review the Health Reform page on web-DENIS.
    • Click on BCBSM Provider Publications and Resources.
    • Click on Newsletters & Resources.
    • Under Health Reform, click on Information.
  • The Record — Reference the health reform articles in September through December 2013 issues.
No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2013 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.