Answers to common questions
How do I know if this applies to me?
If you’re 18 or older, have Blue Cross health insurance through your employer or through Medicaid* and are planning to receive one of the services included in the list above, this program may apply to you.
*Minnesota Health Care Programs (MHCP), including Blue Advantage Families and Children (formerly Prepaid Medical Assistance Program), and MinnesotaCare (MNCare).
If I have one of these services done at a hospital when it should've happened at a lower-cost setting, will I have to pay the full price of the procedure myself?
No, you do not have to pay if a procedure in the site of service medical policy is not performed at the appropriate site of service.
Exceptions: Sometimes hospitals are covered
While, in general, this program is designed to help members get care at ASCs, there are some cases where an in-network hospital is exempt from the policy and is covered:
- Hospitals that have agreed to provide these services at a lower cost for our members
- Hospitals where there is no ASC that provides these services within 25 miles of the hospital
- Hospitals (or other appropriate non-hospital places) where there isn’t an in-network ASC that provides the services within 25 miles of a member’s home
Working to balance cost and quality supports health care sustainability. Learn more about health care sustainability.