Healthy Blue Living: Help
Answers to general questions about how the Healthy Blue Living plan works
Keep checking your to-do list inside your online member account. This is automatically updated with your progress in the plan. Note that it could take up to two weeks for updates to appear in your account.
All renewing members start the new plan year at the same level of benefits where they ended last plan year. If you had standard benefits, you’ll remain at that level until you meet the requirements for enhanced benefits. If you had enhanced benefits, you’ll remain at that level unless you do not meet the requirements for maintaining enhanced benefits. New members are automatically enrolled with enhanced benefits.
Yes, if you are still within the 90 or 120-day window. Once you meet the requirements for scoring an A or B on the health measure(s) that previously scored a C, you can move back to enhanced benefits. This assumes that you’ve completed everything else on your to-do list.
Answers to your questions about your doctor visit, qualification form and health assessment
To avoid this situation, try to schedule your visit as soon as you join Healthy Blue Living. If you're unable to schedule an appointment within the 90-day timeframe, call BCN Customer Service at the number on the back of your member ID card for help. Also, qualification forms are accepted for an office visit that occurred up to 180 days before your plan year began. Your doctor can still complete the form now, even if it's for a past visit.
It starts from the beginning of your plan year. For example, if your plan year starts on January 1, you would have until the end of March to complete the 90-day requirements. Note that the 90-day time period starts the same date that the 120-day time period starts. Also, you can complete your doctor visit and your health assessment now, even if the plan year hasn't started yet. And remember that a primary care visit that occurred during the 180 days before the beginning of the plan year can also count toward this plan year.
Yes, the doctor you schedule your health evaluation with, and who completes your qualification form, must be in the Blue Care Network.
If you had an office visit any time up to 180 days before this plan year started, it counts toward this year's 90-day requirement. Your doctor must still complete and submit a qualification form, even if it's after the fact, and you must follow up to make sure this happens.
Your doctor’s office might not submit your qualification form right after your appointment. Log in to your online member account to check your to-do list a week after your appointment to confirm it’s been submitted. If not, call your doctor’s office to remind them you’re a Blue Care Network member with the Healthy Blue Living plan, and they need to submit the electronic form to us online before your deadline.
Yes. You can access the health assessment from your online member account and complete it on your own without visiting your doctor. It’s a questionnaire that covers topics about you and your lifestyle, well-being, conditions, lab tests and screenings.
Schedule a health evaluation with your Blue Care Network 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 Qualification Form (PDF), complete the Member section, then give it to your doctor as a reminder for them to submit it online. Your provider must submit the form within the first 90 days of your plan year. Your deadline date is posted on the to-do list in your member account.
Yes, qualification forms are accepted for an office visit that occurred up to 180 days before your plan year began. Your doctor can still complete the form now, even if it's with information from a past visit.
No, only you as the primary subscriber need to meet the plan requirements, then everyone on your contract will have enhanced benefits with lower out-of-pocket costs.
One requirement for enhanced benefits is that you must score all A's and B's on your qualification form. An A score means you’re meeting the health targets and a B means you’ve committed to treatment to improve a particular health measure. A C score indicates that you are unwilling to work toward that particular health goal so you will move to standard benefits for the remainder of the plan year.
You don’t need to complete a qualification form and health assessment every year if you score all A's on your most recent qualification form. If you’re younger than 40, you’ll need to submit a qualification form every three years. If you're 40 or older, you'll submit one every two years.
Inquiries related to requirements, deadlines, benefit level or completion status should be made through your online member account under the “To-Do List” tab. If you don't see a status confirming your completion of the requirements, remember to allow seven days for any changes to appear. If you still don't see the information after seven days, confirm with your primary care provider if the qualification form was submitted and if any C scores were given in error. For additional questions, or if the health assessment is not showing as complete, call the number on the back of your BCN member ID card.
Answers to general questions about the 120-day requirements
It starts from the beginning of your plan year. For example, if your plan year starts on January 1, you would have until the end of June to complete the 120-day requirements. Note that the 120-day time period starts the same date that the 90-day time period starts.
Yes. WeightWatchers is available to all members for a discounted price. To redeem the discount, members can log in to their online member account and then click Member Discounts with Blue365® on the right side of the screen. Tobacco Coaching is available at no extra cost to all Blue Care Network members as part of their base benefit.
Answers to your questions about the weight management program options
You must attend at least 11 out of 13 weekly workshops for each three-month subscription and then reenroll in a new three-month subscription once the previous one ends. Do this until your doctor submits a new qualification form that shows you have a BMI below 30.
You must average at least 5,000 steps per day for each three-month period from when you first sign up for the program. Do this until your doctor submits a new qualification form that shows you have a BMI below 30.
You’ll be keeping track of your weight as you move through the Steps walking program. You can also track your BMI using an online BMI calculator, which requires only your height and weight. When your BMI reaches 29 or lower, schedule a health evaluation with your doctor to complete a new qualification form.
When your BMI reaches 29 or lower, schedule a health evaluation with your doctor to complete a new qualification form.
Answers to your questions about the Tobacco Coaching and Lifestyle Coaching programs
Tobacco Coaching consists of five monthly calls. During the first call, you need to tell your coach your planned quit date. If you don’t agree to set a quit date after your first call, or you don’t quit after five calls, you must enroll and participate in monthly Lifestyle Coaching calls. This program continues until your doctor submits a new qualification form that shows a negative cotinine test.
With Tobacco Coaching, you participate in five coaching calls within a 12-week period. Your health coach will ask you to set a quit date during your first call. If you agree to set one, you’ll proceed with the program. If you don’t, you’ll be required to join monthly Lifestyle Coaching calls. Lifestyle Coaching is also telephone-based and requires you to work with a health coach on improving your health. With Lifestyle Coaching, you must participate in one call a month until we receive a qualification form that shows a negative cotinine test.
Lifestyle Coaching consists of one call a month and continues until we receive a qualification form that shows a negative cotinine test.