Health Insurance Carrier Network Information

BlueCross BlueShield of Tennessee and Cigna, our health insurance carriers, administer the medical network options. Both carriers offer expansive networks of doctors, hospitals and facilities. For additional information about participating hospitals, please carefully review all information provided below, including the hospital list and other network information.

BCBST

BlueCross BlueShield of Tennessee
800.558.6213
Monday - Friday, 7 - 5 CT
bcbst.com/members/tn_state/

Cigna

Cigna
800.997.1617
24/7
cigna.com/stateoftn


Find out if your providers are in the networks

 
BCBST Cigna
View PDF hospital list All Networks Hospital ListBlue Cross Blue Sheild  All Networks Hospital List
Search carrier website for providers Network S
Network P
LocalPlus
Open Access Plus
Download PDF provider directory
2024

Network S

Network P

Local Plus—Volume 1
Local Plus—Volume 2

Open Access Plus—Volume 1
Open Access Plus—Volume 2

Contact carrier for help 800.558.6213 800.997.1617

 

You can choose from  four carrier networks for your medical care.

BlueCross BlueShield Network S
Cigna LocalPlus

These networks include many providers, hospitals and facilities throughout Tennessee and across the country. Not all providers and hospitals are in BlueCross Network S and Cigna Local Plus networks, which helps keep premiums and claims costs low. There is no additional monthly cost added to the premium for the BlueCross Network S or Cigna LP networks.

BlueCross BlueShield Network P
Cigna Open Access Plus

These networks include more hospitals and facilities. There is an additional cost added to the monthly premium for the BlueCross Network P and Cigna OAP networks. You may also pay more per claim because the costs for services in these networks are generally higher than the other two networks.

  • Employee-only tier - Additional $75 per month
  • Employee + child(ren) tier - Additional $85 per month
  • Employee + spouse and Employee + spouse + child(ren) tiers - Additional $150 per month

It’s important to check the networks carefully when making your selection. You will keep the network you choose for the current plan year, subject to continued eligibility. You can make changes during the plan’s next Annual Enrollment period.  You may be able to make changes allowed by the plan if you have a qualifying event. Information about qualifying events is on page three of the Enrollment Change Application.

Network providers and facilities can and do change. Benefits Administration cannot guarantee all providers and hospitals in a network at the beginning of the year will stay in that network for the entire year. A provider or hospital leaving a network is not a qualifying event and does not allow you to make changes to your insurance choices.

If you use providers outside of the network, you will be charged out-of-network rates unless certain rights and protections apply. Your insurance ID card shows your carrier and network.

Information in provider directories is accurate at the time of publication. Providers and hospitals in the carriers' networks can change after documents are published. You can verify the network status of your preferred providers before receiving care by calling BCBST or Cigna member services or by using the online provider search on the carrier websites.


Covered Services

The carriers' covered services are generally the same whether you choose BCBST or Cigna. For some procedures, different medical criteria may apply based on the carrier you select. For detailed information on covered services, exclusions, and how the plans work, view the BCBST or Cigna member handbooks and your Plan Document, available on the Publications page. If you have questions about your benefits or medical criteria for a specific service, contact the carriers’ member services number on the back of your medical insurance card.


Coordination of Benefits

Coordination of benefits rules decide which insurance plan pays your claims first, how much each plan will pay, and how much you will pay.

Double coverage means you have insurance under two medical plans. For example:
·    you might be enrolled in the State Group Insurance Program* plus another employer plan; or (for example, as an employee in the state plan and as a dependent, spouse or child in the local education plan)
·    you might be enrolled in two State Group Insurance Program* plans; or
·    you might be enrolled in Medicare as your primary coverage and in a State Group Insurance Program* plan as your secondary coverage

Coordination of benefits will be applied to your claims so that:
·    if you have other primary medical coverage and secondary medical coverage with this plan, you will pay any cost share required by this plan.
·    if you have primary and secondary coverage with this plan, you will pay the cost share required by this plan’s secondary coverage.

See examples.

*The State Group Insurance Program, also referenced as “this plan”, includes three separate plans: State/Higher Education, Local Education and Local Government.