Within Your First 90 Days
Complete the steps required during the first 90 days of your Healthy Blue Living plan start date so you can maintain enhanced benefits.
Two steps forward
You have the first 90 days of your plan year to complete these two action items and maintain your enhanced benefits, with lower out-of-pocket costs.
Step 1: Completing a qualification form
Step 2: Completing the health assessment
How the qualification form works
- Schedule a health evaluation with your primary care provider.
- Your provider should have the qualification form and may make notes on it during your appointment. They will then submit the form electronically. As an option, you can download the form, complete the Member section, then give it to your doctor as a reminder for them to submit it online.
- The form must be submitted electronically, not by fax, within the first 90 days of your plan year. Your deadline date is posted within your Healthy Blue Living To-Do's in your online account.
Your doctor will score each health measure with an A, B or C during your appointment.
A = You’ve met the recommended target.
B = You didn’t meet the recommended target, but you’ve agreed to take the right steps to improve the health measure.
C = You didn’t meet the recommended target and you won’t commit to your doctor’s treatment plan or enroll in a BCN program for weight management or tobacco cessation.
A's and B's will keep your out-of-pocket costs lower, with enhanced benefits, if you also complete all items on your Healthy Blue Living To-Do's. If you score a C on any measure, you will move to standard benefits and your costs will be higher.
You don’t need to wait until your new plan year starts to see your doctor. We’ll accept a qualification form from an office visit that occurred up to 180 days before the start of your plan year.
Lab work is a routine part of the health evaluation. Work with your doctor's office to complete lab work as efficiently as possible. Along with standard lab work, a cotinine test is required for new members who are not self-reported tobacco users.
You don’t need to complete a qualification form and health assessment every year if you scored all A's on your most recent qualification form. If you’re younger than 40, you’ll need to submit a new form every three years. If you're 40 or older, you'll submit one every two years.
- Schedule a health evaluation with your primary care provider.
- Your provider should have the qualification form and may make notes on it during your appointment. They will then submit the form electronically. As an option, you can download the form, complete the Member section, then give it to your doctor as a reminder for them to submit it online.
- The form must be submitted electronically, not by fax, within the first 90 days of your plan year. Your deadline date is posted within your Healthy Blue Living To-Do's in your online account.
Your doctor will score each health measure with an A, B or C during your appointment.
A = You’ve met the recommended target.
B = You didn’t meet the recommended target, but you’ve agreed to take the right steps to improve the health measure.
C = You didn’t meet the recommended target and you won’t commit to your doctor’s treatment plan or enroll in a BCN program for weight management or tobacco cessation.
A's and B's will keep your out-of-pocket costs lower, with enhanced benefits, if you also complete all items on your Healthy Blue Living To-Do's. If you score a C on any measure, you will move to standard benefits and your costs will be higher.
You don’t need to wait until your new plan year starts to see your doctor. We’ll accept a qualification form from an office visit that occurred up to 180 days before the start of your plan year.
Lab work is a routine part of the health evaluation. Work with your doctor's office to complete lab work as efficiently as possible. Along with standard lab work, a cotinine test is required for new members who are not self-reported tobacco users.
You don’t need to complete a qualification form and health assessment every year if you scored all A's on your most recent qualification form. If you’re younger than 40, you’ll need to submit a new form every three years. If you're 40 or older, you'll submit one every two years.
Maintaining your enhanced benefits
Keep track of these checkpoints
In the first 90 days:
- Make sure your primary care provider is in the Blue Care Network
- Schedule and complete a health evaluation visit with your in-network primary care provider
- Log in to your online account a week after your appointment to confirm that your qualification form has been submitted
- Score all A's and B's on your qualification form
- Complete your online health assessment
Your Healthy Blue Living to-do's
See exactly where you are in the plan and what you need to do next. Just log in to your online account, select My Coverage, then Medical, then Healthy Blue Living To-Do's.
contact us
We're here to help
For help reaching your goals or if you have other questions, call the number on the back of your BCN member ID card.
For technical support with the website or your member account login, call 1-888-417-3479.