Networks change. We verify your specific Blue Cross Blue Shield BlueCard and Out-of-State Blue Plans plan before your first visit; call with your member ID and we will confirm benefits, copay and any referral or authorization requirements.
Also appears on cards as: BCBS, BlueCard, Anthem, Anthem Blue Cross, Empire BlueCross, Horizon Blue Cross Blue Shield, Highmark, CareFirst, out-of-state Blue plans.
Blue Cross Blue Shield is not one company but a federation of independent licensees, each covering its own state. If your card comes from Anthem, Empire, Horizon, Highmark, CareFirst or another Blue plan outside Florida or South Carolina, the BlueCard program lets you use providers who contract with the local Blue plan, which is Florida Blue in Florida and BlueCross BlueShield of South Carolina in South Carolina, at in-network rates. Snowbirds, students, relocated retirees and people who work remotely for an out-of-state employer typically fall into this group. For most PPO plans, an outpatient psychiatry visit costs a specialist copay or coinsurance set by your home plan, and referrals are not required for behavioral health. Some HMO products from other states limit out-of-area care to emergencies, so check for the suitcase symbol on your card.
Telehealth is typically covered at parity with office visits under your home plan's rules, and you must be physically in Florida or South Carolina during the visit so that our provider is licensed where you are. Claims are filed with the local Blue plan and routed to your home plan, which decides what is covered and what you owe. For Deep TMS, your home Blue plan's medical policy applies, and most plans require prior authorization with documentation of major depressive disorder, failure of at least two antidepressants and a current severity score. Spravato typically requires prior authorization under the home plan's medical or specialty pharmacy benefit, with treatment-resistant depression, a concurrent oral antidepressant and REMS-certified administration documented. Our staff identify your home plan from the card and submit requests to the right office.
What we check before your visit
- Whether your plan is in network at the office you chose and for telehealth
- Your copay or coinsurance for an evaluation and for follow-ups
- Whether a primary-care referral is required (common with HMO plans)
- Prior-authorization criteria for Deep TMS and Spravato, if those are being considered
Frequently asked questions
My Blue Cross card is from another state. Can I still see Stedfast Psychiatry in network?
Usually, yes. If your card shows the suitcase logo, your plan participates in BlueCard, and you can see providers who contract with the local Blue plan at in-network rates in Florida or South Carolina. Call the member number on your card, or give our front desk your card details and we will confirm eligibility before your first visit.
Who decides my copay, the local Blue plan or my home plan?
Your home plan. The local Blue plan prices the claim at its contracted rate and sends it to the plan that issued your card, which applies your deductible, copay or coinsurance. The result is typically the same specialist cost share you would pay for a psychiatry visit at home. Our staff can request an estimate before your appointment.
Does BlueCard cover telehealth visits while I am in Florida or South Carolina?
Most out-of-state Blue plans cover video psychiatry visits at parity with office visits when you see an in-network provider, and BlueCard extends that to our providers while you are in Florida or South Carolina. You need to be physically in one of those states during the visit. A few plans limit telehealth to their own vendor, so we confirm first.
How does prior authorization work for Deep TMS or Spravato on an out-of-state Blue plan?
Your home plan reviews the request under its own medical policy. Most Blue plans require prior authorization for both treatments and ask for documentation of treatment-resistant depression, prior medication trials and a current symptom score. Our team identifies the correct authorization office from your card, submits the records, and schedules once approval is in hand.