Member Handbook (2014)
• Handbook Update: July 2012
The COVA Care plan provides a wide range of health care services for medical, behavioral health, dental, vision, hearing and pharmacy needs.
The plan offers several benefit options:
- Basic (includes dental)
- Expanded Dental
- Vision, Hearing and Expanded Dental
- Out of Network, Expanded Dental, Vision and Hearing
The level of coverage the employee receives is based on the benefit option chosen which varies with the premium paid. No primary care physician selection is required and no referrals are needed to visit a network specialist. Co-payments and deductibles apply. Prescription drugs are divided into four tiers and the employee pays the appropriate prescription co-payment by tier ($15, $30, $45, and $55 for a 34-day supply).
COVA Care members receive a single ID Card that can be utilized for each plan.
COVA Care members have coverage within both the Anthem and the BlueCard PPO networks. Except in an emergency, coverage must be in-network only, unless the member has purchased the Out-of-Network option.
Anthem BC/BS Network:COVA Care covers medical care provided by hospitals, primary care physicians and specialists. To see a primary care physician or a specialist, visit the Anthem network directory of providers at www.anthem.com or call at 800-552-2682. There is a $25 co-payment for a primary care physician visit and a $40 co-payment for a specialist.
BlueCard PPO Program -- for care within the United States:Through the BlueCard PPO program, your Anthem BC/BS ID card is accepted throughout the country. To locate a BlueCard PPO physician or hospital, call 800-810-BLUE(2583) or use the BlueCard Doctor and Hospital Finder. 85% of all United States hospitals and physicians participate in the program.
BlueCard Worldwide -- for care outside the United States:COVA Care members who live or travel outside the US will receive the highest level of benefits when their care is coordinated through the BlueCard Worldwide Service Center. For a hospital list, visit BlueCard Worldwide or call 800-810-BLUE(2583) or collect at 804-673-1177.
Optional Vision and Hearing benefit:If you have selected the optional vision benefit, you have Blue View Vision. For a list of benefits and providers, please go to Blue View Vision. You may also call 800-552-2682 for assistance.