Blue Elect Plus members don’t need referrals

Health care providers should be aware that members enrolled in Blue Care Network’s Blue Elect Plus℠ point‑of‑service plan don’t need referrals to see a specialist.

When a patient calls a specialist for an appointment, their office staff needs to verify whether the member has BCN HMO or the Blue Elect Plus POS coverage. Keep in mind that BCN members can have HMO or POS benefits.

Blue Elect Plus is a point‑of‑service plan that doesn’t require referrals to see a specialist, either in or out of network. The member ID card prefix is the same prefix that’s on the member ID card for HMO coverage. But the plastic member ID card specifically indicates “POS” coverage.

In addition, wording on the back of the member ID card notes that referrals aren’t required for Blue Elect Plus. By contrast, the virtual member ID card doesn’t indicate that the member is in a point-of-service plan. That’s why it’s always important to check web‑DENIS for eligibility and benefits.

For Blue Elect Plus, some services, including most preventive care, are only covered when received from a network provider. Providers should also be aware that some services require prior authorization.