Medical

Your plan options

You have three medical plan options through Blue Cross Blue Shield of Tennessee (BCBST) to choose from:

• Basic CDHP
• Enhanced CDHP
• PPO Plan

All three plans cover preventive care at 100% as well as doctor’s office visits, prescriptions, mental health care, hospitalizations and other services.

If you enroll in the Basic CDHP or the Enhanced CDHP, you can contribute to a tax-advantaged Health Savings Account (HSAAn account that lets you save pre-tax dollars to pay for eligible healthcare expenses in the current year and beyond.) and receive a contribution from Frontdoor.

How it works

1. 1

   Before you get care

   • Know what’s in networkDoctors, hospitals and pharmacies that have agreed to the plan's discounted rates, so you pay less when you use them., where to go for care and whether your care needs prior authorizationPrior authorization (also called preauthorization, precertification, or prior approval) is an approval from a health insurance company that a doctor or patient must receive before a specific medical service, procedure, device, or prescription drug will be covered..
   • Choose an in-network primary care provider (PCP)A doctor who provides routine care, helps manage your overall health, and coordinates specialist care when needed. who can get to know you and understand your medical history.
2. 2

   When you get care

   In-network preventive care is covered 100%. The amount you pay for non-preventive care depends on your medical plan:

   • Basic CDHP or Enhanced CDHP: You pay the deductibleThe amount you pay for care before the plan begins to pay. first, and then you and the plan share the cost (coinsuranceThe percentage of the cost of care that you pay after you meet your deductible.). You can use your HSA to pay for out-of-pocket expenses.
   • PPO Plan: You pay copaysA set amount you pay for care, usually at the time you receive a service or fill a prescription. for doctor’s office visits or emergency room visits. Other services, like inpatient and outpatient care, have a deductibleThe amount you pay for care before the plan begins to pay. you need to meet first, and then you and the plan share the cost (coinsuranceThe percentage of the cost of care that you pay after you meet your deductible.). You can use your Health Care Flexible Spending Account (if you have one) to pay for out-of-pocket expenses.
3. 3

   After you get care

   Your provider submits a claim. You’ll receive an Explanation of Benefits showing what the plan paid and what you may owe.

4. 4

   An out-of-pocket maximumThe most you pay for covered care during a calendar year. protects you.

   Once you reach that limit, the plan pays 100% of covered in-network care for the rest of the year.

What you pay for in-network care

Below is a brief overview of in-network costs. See full plan details by clicking on the plan names.

* Domestic partners are not considered qualified dependents under the Internal Revenue Code, Section 152. Thus, the tax treatment for domestic partners must be handled differently than for qualified dependents.

Learn about Prescription Medication Coverage

Using your medical benefits

Get more from your coverage with these tools, services and resources. Visit the BCBST member portal and register for an account to find care and manage your care.