Doctor-ordered services
As part of your care, your doctor may order medical equipment and clinical lab and specialty pharmacy services. You may want to get these from a participating, or in-network, provider to save money.
If you get medical services from a non-participating provider, eligible medical products and services will be processed at a higher, out-of-network rate.
When is a service in-network or out-of-network?
With D/HME services, medical equipment is rented or bought from a retail store, or ordered and shipped to your home:
- Hospital beds
- Crutches
- Wheelchairs
- Oxygen tanks
- Respiratory therapy machines
In-network D/HME providers should participate in a Blue Plan in the state the equipment is shipped to, or the location of the store if it’s purchased at a retail location.
In-network specialty pharmacies should participate in a Blue Plan in the state where the ordering physician is located. Services include:
- Injectables and infusion therapies
- High-cost therapies
- Complex care therapies