BCBSNE and CHI have reached an agreement

We are pleased to announce that Blue Cross and Blue Shield of Nebraska (BCBSNE) has signed two agreements with UniNet Healthcare Network, the contracting entity for Denver-based CHI Health, that bring CHI back into our NEtwork BLUE provider network. As a result, UniNet-affiliated physicians in Omaha and CHI Health facilities across the state will again be contracting with BCBSNE for our health plans that utilize the NEtwork BLUE provider network. Both agreements, one for the Omaha-metro area and one for the rest of the state, are effective July 15, 2015.

This applies only to our health plans that use the NEtwork BLUE network. It does not apply to SelectBlue three-tier plans. CHI Health will remain fully out of network for members enrolled in SelectBlue plans. Members may continue to access care in the Select BlueChoice network which includes: Nebraska Medicine-Nebraska Medical Center, Nebraska Medicine-Bellevue, Nebraska Orthopaedic Hospital, Methodist Health System, Methodist Women’s Hospital, Methodist Hospital, Children’s Hospital & Medical Center and Children’s Physicians, Fremont Health, Methodist Jennie Edmundson Hospital and SecureCare.

Throughout the negotiation process, BCBSNE advocated for an agreement that was fair and beneficial to our members and addressed CHI Health’s higher costs in Omaha. We are satisfied with the new agreements and welcome CHI Health facilities and physicians back into our Network BLUE PPO network.

We want to make sure members understand the impact of the new agreements. We invite members to call the number on the back of their BCBSNE member ID card with questions. One of our customer service representatives will be happy to help. We promise to continue to work on solutions to improve quality and affordability for all our members.

Thank you for your continued trust in us.

Sincerely,

Pat Bourne
Senior Vice President, Sales and Account Management

HEALTH INSURANCE TERMS

Affordable Care act

The Affordable Care Act (ACA), sometimes called Obamacare, is a federal law designed to make health care more affordable, accessible and of higher quality.

COINSURANCE

The percentage of the bill you pay after your deductible has been met.

COPAY

A fixed amount you pay when you get a covered health service.

DEDUCTIBLE

The annual amount you pay for covered health services before your insurance begins to pay.

emergency care services

Any covered services received in a hospital emergency room setting.

health insurance marketplace (exchange)

The government Website (healthcare.gov) where you can purchase health insurance and see if you qualify for a tax credit (subsidy) to help pay premiums and out-of-pocket costs. 

in-network provider

A provider contracted by your insurance company to accept an agreed upon payment for covered services. 

OUT-OF-network provider

A term for providers that aren’t contracting with your insurance company. (Your out-of-pocket costs will tend to be more expensive if you go to an out-of-network provider.)

out-of-pocket

Your expenses for medical care that aren’t reimbursed by insurance, including deductibles, coinsurance and co-payments.

penalty

If you can afford health insurance, but choose not to buy it, you must have a health coverage exemption or pay a tax penalty on your federal income tax return.

premium

The amount you pay to your health insurance company each month. 


Preventive services

Health care services that focus on the prevention of disease and health maintenance.

rehab SERVICES

Services and devices to help you recover if you are injured or have surgery. This includes physical, occupational and speech therapy.

special enrollment period

The time after the Open Enrollment Period when you can still purchase health insurance only if you have a qualifying life event (losing other health coverage, having a baby, getting married, moving).

specialist

A physician who has a majority of his or her practice in fields other than internal or general medicine, obstetrics/gynecology, pediatrics or family practice.

SUBSTANCE ABUSE DISORDER SERVICES

Includes behavioral health treatment, counseling, and psychotherapy.

tax credit

Financial assistance from the government that helps those who are eligible pay for health insurance. Eligibility is generally determined by household income and family size.

Tiered benefit plan

A health care plan featuring multiple levels of benefits based on the network status of a particular provider.