The BMCS Open Choice plans, gives you freedom of choice by allowing you to choose your own doctors and hospitals. You can maximize your coverage by accessing your care through Aetna Open Choice's network of hospitals, doctors, and specialists. Of course, with the Open Choice plans, you have the freedom to select providers who do not participate in the Aetna Open Choice network. However, if you receive services from out-of-network providers, you will have higher out-of-pocket costs and may have to submit your claim for reimbursement.
With the BMCS Open Choice plans...
• You do not need to enroll with a primary care physician
• You never need referrals
For more information regarding your medical plans, go to www.bmshc.aetna.com.
BMCS POS lets you maintain freedom of choice by allowing you to select your own doctors and hospitals. You maximize your coverage by having care provided or referred by your primary care physician (PCP). Of course, with BMCS POS, you have the freedom to self-refer your care to providers who do not participate in our network; however, higher out-of-pocket costs apply. This program may not cover all your health care services.
To get the most out of your benefits program, below are some key terms that you will need to understand.
• Referral - Documentation from your PCP authorizing care at a participating specialist for covered services.
• Preauthorization - Approval from Aetna for non-emergency or elective hospital admissions and procedures prior to the admission or procedure. For in-network (referred) services, your participating provider will contact Aetna for authorization. For out-of-network (self-referred) services, you are responsible for obtaining approval for certain services.
• Designated site - PCPs are required to choose one radiology, physical therapy, occupational therapy, laboratory, and routine foot care provider where they will send all their Aetna members.