Host Plan definition
Examples of Host Plan in a sentence
In some cases, the Host Plan will engage a third party to assist in identification or collection of recovery amounts.
The Host Plan will be responsible for providing such services as contracting with its participating providers and handling substantially all interactions with its participating providers and, as applicable, providing some managed care services.
Under the BlueCard Program, recoveries from a Host Plan or from participating providers of a Host Plan can arise in several ways.
As an alternative to the BlueCard Program, Member claims for covered health care services may be processed through a negotiated national account arrangement with a Host Plan.
If Blue Cross and Blue Shield enters into a Negotiated National Account Arrangement with a Host Plan to provide Value-Based Programs to your Members, Blue Cross and Blue Shield will follow the same procedures for Value-Based Programs administration as noted in the BlueCard Program section.
The Host Plan will provide you with an explanation of your benefits and Copayments.
If you will be living outside of the Home Plan's service area for more than 90 days, but will maintain a permanent residence within the Plan's service area, the Home Plan will establish a Guest Membership for you with a Host Plan serving the area in which you will be staying.
Under the BlueCard Program, when Members access covered health care services in a geographic area served by a Host Plan, Blue Cross and Blue Shield will remain responsible for fulfilling the obligations of this Agreement.
When Members receive covered health care services outside the United States, Puerto Rico, and the U.S. Virgin Islands, there is no available geographic area served by a Host Plan.
Typically, Members accessing care outside of Massachusetts obtain care from providers that have a contractual agreement (that is, are “participating providers”) with the local Blue Cross and/or Blue Shield Licensee in that other geographic area (referred to in this Agreement as Host Plan or local Blue Cross and/or Blue Shield Plan).