Common use of Health Care Services Furnished Outside of Massachusetts Clause in Contracts

Health Care Services Furnished Outside of Massachusetts. Blue Cross and Blue Shield has a variety of relationships with other Blue Cross and/or Blue Shield Licensees referred to generally as “Inter-Plan Programs.” Whenever Members access health care services outside of Massachusetts, the claim for those services may be processed through one of these Inter-Plan Programs and presented to Blue Cross and Blue Shield for payment. The Inter-Plan Programs available to Members under this Agreement are described generally below. Typically, Members accessing care outside of Massachusetts obtain care from providers that have a contractual agreement (that is, are “participating providers”) with the local Blue Cross and/or Blue Shield Licensee in that other geographic area (referred to in this Agreement as Host Plan or local Blue Cross and/or Blue Shield Plan). In some instances, Members may obtain care from non-participating providers. Members’ health care benefits for participating and non-participating providers are fully described in the Subscriber Certificates for your benefits plans. The BlueCard® Program Under the BlueCard Program, when Members access covered health care services in a geographic area served by a Host Plan, Blue Cross and Blue Shield will remain responsible for fulfilling the obligations of this Agreement. The Host Plan will be responsible for providing such services as contracting with its participating providers and handling substantially all interactions with its participating providers and, as applicable, providing some managed care services.

Health Care Services Furnished Outside of Massachusetts. Blue Cross and Blue Shield has a variety of relationships with other Blue Cross and/or Blue Shield Licensees referred to generally as “Inter-Plan Programs.” Whenever Members access health care services outside of Massachusetts, the claim for those services may be processed through one of these Inter-Plan Programs and presented to Blue Cross and Blue Shield for paymentpayment in compliance with the Inter-Plan Programs policies then in effect. The Inter-Plan Programs available to Members under this Agreement are described generally below. Typically, Members accessing care outside of Massachusetts obtain care from providers that have a contractual agreement (that is, are “participating providers”) with the local Blue Cross and/or Blue Shield Licensee in that other geographic area (referred to in this Agreement as Host Plan Plan, Host Blue or local Blue Cross and/or Blue Shield Plan). In some instances, Members may obtain care from non-participating providers. Members’ health care benefits for participating and non-participating providers are fully described in the Subscriber Certificates for your benefits plans. The BlueCard® Program Under the BlueCard Program, when Members access covered health care services in a geographic area served by a Host Plan, Blue Cross and Blue Shield will remain responsible for fulfilling the obligations of this Agreement. The Host Plan will be responsible for providing such services as contracting with its participating providers and handling substantially all interactions with its participating providers and, as applicable, providing some managed care services.

Health Care Services Furnished Outside of Massachusetts. Blue Cross and Blue Shield has a variety of relationships with other Blue Cross and/or Blue Shield Licensees referred to generally as “Inter-Plan Programs.” Whenever Members access health care services outside of Massachusetts, the claim for those services may be processed through one of these Inter-Plan Programs and presented to Blue Cross and Blue Shield for payment. The Inter-Plan Programs available to Members under this Agreement are described generally below. Typically, Members accessing care outside of Massachusetts obtain care from providers that have a contractual agreement (that is, are “participating providers”) with the local Blue Cross and/or Blue Shield Licensee in that other geographic area (referred to in this Agreement as Host Plan Plan, Host Blue or local Blue Cross and/or Blue Shield Plan). In some instances, Members may obtain care from non-participating providers. Members’ health care benefits for participating and non-participating providers are fully described in the Subscriber Certificates for your benefits plans. The BlueCard® Program Under the BlueCard Program, when Members access covered health care services in a geographic area served by a Host Plan, Blue Cross and Blue Shield will remain responsible for fulfilling the obligations of this Agreement. The Host Plan will be responsible for providing such services as contracting with its participating providers and handling substantially all interactions with its participating providers and, as applicable, providing some managed care services.

Health Care Services Furnished Outside of Massachusetts. Blue Cross and Blue Shield has a variety of relationships with other Blue Cross and/or Blue Shield Licensees referred to generally as “Inter-Plan Programs.” Whenever Members access health care services outside of Massachusetts, the claim for those services may be processed through one of these Inter-Plan Programs and presented to Blue Cross and Blue Shield for paymentpayment in compliance with the Inter-Plan Programs policies then in effect. The Inter-Plan Programs available to Members under this Agreement are described generally below. Typically, Members accessing care outside of Massachusetts obtain care from providers that have a contractual agreement (that is, are “participating providers”) with the local Blue Cross and/or Blue Shield Licensee in that other geographic area (referred to in this Agreement as Host Plan or local Blue Cross and/or Blue Shield Plan). In some instances, Members may obtain care from non-participating providers. Members’ health care benefits for participating and non-participating providers are fully described in the Subscriber Certificates for your benefits plans. The BlueCard® Program Under the BlueCard Program, when Members access covered health care services in a geographic area served by a Host Plan, Blue Cross and Blue Shield will remain responsible for fulfilling the obligations of this Agreement. The Host Plan will be responsible for providing such services as contracting with its participating providers and handling substantially all interactions with its participating providers and, as applicable, providing some managed care services.