Frequently Asked Questions

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Benefits & Coverage

When will a change to my primary care physician PCP selection be effective?

The change will be effective on the first day of the following month. For example, if you make your request on July 20, the change will be effective on August 1. Remember to ask Customer Service if your chosen PCP will be accepting new patients. Please note that the selection of a PCP is required only for BlueCHiP members.

How can I find a participating provider?

You can find a participating provider by visiting our Provider Finder tool. Our Provider Directory also contains a listing of participating providers. You can obtain a Provider Directory by contacting Customer Service at the number listed on your ID card or by requesting one through our Secure Messaging mailbox.

What’s the difference between a referral and an authorization?

A referral is an approval from your PCP to receive care provided by a specialist. To determine if your plan requires referrals for visits to specialists, please visit Plans & Services, and read the information about your plan.

An authorization is an approval for coverage from BCBSRI. Some plans require that you obtain an authorization before receiving certain services, and some only recommend that you obtain one. To determine whether an authorization is recommended or required under your plan, please visit Plans & Services, and read the information about your plan. To access a list of services for which an authorization is recommended or required, please refer to your benefit summary.

Whose responsibility is it to obtain any necessary authorizations?

If you visit a participating provider, it’s the provider’s responsibility. If you visit a non-participating provider, it’s your responsibility to obtain the authorization.

Do I need to pay a copayment at the time of my visit?

If your plan requires a copayment for certain services, you must pay it at the time of treatment.

What are my copayment amounts?

Copayment amounts differ from plan to plan. Use one of the methods below to determine your copayments amounts:

How do I get reimbursed for the medical expenses I paid?

If your medical expenses are eligible for reimbursement, please submit your receipts, along with your name, address, and member ID number to:

Blue Cross & Blue Shield of Rhode Island
Attention: Claims Department
500 Exchange Street
Providence, RI 02903

The information that’s required depends on the type of expenses you are submitting for reimbursement. Please contact Customer Service for assistance with submitting receipts.

How can I get a replacement ID card?

To request a replacement ID card for yourself or a covered family member, visit Member Self-Service, choose Replacement ID Card, and follow the instructions on the screen. You also can request a replacement card by calling our Customer Service Department.

How do I change my address?

Please visit Member Self-Service, choose Change Address, and follow the instruction on the screen. You also can change your address by contacting Customer Service.

Can I add my grandchild to my policy?

Your grandchild qualifies as an eligible dependent only if you become his or her legal guardian. If this is the case, please check with your employer for specific instructions about adding your grandchild to your policy.

Until what age is my dependent child covered under my policy?

Your unmarried child is eligible for coverage until December 31 of the year in which he or she reaches the maximum dependent age indicated in the Subscriber Agreement. If your child is above the maximum dependent age, he or she may be eligible for coverage as a full-time or part-time student. Dependent students attending qualified schools and programs are eligible for coverage until December 31 of the year in which they reach the maximum student age indicated in the Subscriber Agreement.

What services does Catamaran Home Delivery provide for BCBSRI members?

Catamaran Home Delivery handles your prescription drug claims, requests for mail order drugs, and a variety of other pharmacy services.

How can I access prescription drug information online?

You must be registered on BCBSRI.com. If you're not registered yet, simply click Register at the top of the page and follow the instructions. Once you're registered, sign in with your user name and password, then click on Pharmacy from your member page. You will have access to a variety of pharmacy tools and information.

Which pharmacies are in the network?

Our pharmacy network includes more than 60,000 pharmacies nationwide, including most major chain stores and many local, independently owned pharmacies.

How do I change pharmacies?

Although our pharmacy benefit manager is Catamaran as of January 1, 2013, you may use any of the 60,000 participating pharmacies in our network.

If you would like to switch to a new pharmacy, you may do so in one of two ways:

1. Bring your prescription bottle(s) to the new participating pharmacy. The pharmacist will contact your previous pharmacy and arrange for your prescriptions to be transferred. The pharmacist will also confirm the dosage and directions for use, and then cancel your prescription at your previous pharmacy.


2. Request a new written prescription from your doctor, and bring it to the new pharmacy to be filled. 

How do I use the mail order drug service?

You can use Catamaran Home Delivery to receive up to a 90-day supply of your medicine at one time. To get started, fill out the Mail Service Order Form. Visit the Catamaran Home Delivery page for more information. You can also click on the Pharmacy link on the left-hand side of you member homepage to use the online pharmacy tools.

Whom do I contact with questions about prescription drug coverage or about Catamaran Home Delivery?

If you have any questions about your pharmacy benefits, please call Customer Service.