MESSA Choices II

The MESSA Choices II program offers in-network and out-of-network benefits.  MESSA Choices II uses a large network of high-quality health care providers to deliver the medical care and services you need while minimizing your out-of-pocket expenses.  Choices II provider network is the Community Blue PPO network.  It is made up of health care providers who deliver services to members through a discounted fee arrangement.  Plan members are given incentives, such as lower out-of-pocket expenses and additional covered services, for using network providers.

In-network benefits include

  • No deductible
  • $5 co-payment on office visits; no copayment on many services
  • Unilimited lifetime maximum
  • Well-child checkups through age 15
  • Immunizations through age 15, as recommended by the Advisory Committee on Immunization Practices and the American Academy of Pediatrics
  • Routine physicals and screening tests

Referrals to Out-of-Network Providers:

When You Use an Out-of-Network Provider With a Referral from a Network Provider

Your network physician must give you authorization via a referral form which you take to your first visit with the specialist.

  • Your out-of-network co-payment is waived
  • Your deductible is waived

 

When You Use an Out-of-Network Provider Without a Referral

With a BCBSM participating provider With a Non-participating provider

You pay:

  • $250/$500 deductible

  • 20% co-payment for office visits

  • 20% co-payment for diagnostic testing

You pay:

  • $250/$500 deductible

  • 20% co-payment for most other services

  • Charges in excess of approved amounts

You have:

  • No balance billing

  • No claim forms

You may have:

  • Balance billings

  • Claim Forms