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Florida Blue and BCBS FloridaUsing your Florida Blue or BCBS Florida plan for virtual outpatient treatment.
Florida Blue (the Blue Cross and Blue Shield licensee for Florida, part of GuideWell) covers a large share of the commercial and individual market in the state. If you spend part of the year in Florida and the rest somewhere else, your out-of-network behavioral benefit is often what travels with you. We verify yours specifically before you commit to anything.
The honest version.
We are out of network with commercial carriers. In-network credentialing is in progress. We verify your out-of-network benefits and tell you the real out-of-pocket number before you start.
What we will and will not tell you about cost.
We do not waive cost-shares. We do not tell you treatment is free. We verify your OON benefits, give you the real number, and if cost is a genuine barrier we will talk about it case by case.
BlueOptions, BlueCare, and the snowbird question.
Florida Blue is the GuideWell Blue Cross and Blue Shield licensee for the state of Florida. Its commercial products range from BlueOptions PPO plans, which usually include an out-of-network benefit, to BlueCare HMO products, which usually do not pay out of network except for emergencies. Florida Blue also administers many self-funded employer plans, where the employer's plan document controls the out-of-network behavioral benefit. The structure that matters for treatment is whether your specific plan carries an out-of-network behavioral health benefit at all, and what its terms are. We pull that for you before anything starts.
The pieces of the plan
- An allowed amount for each kind of visit or day of behavioral care.
- A deductible you meet before the plan starts splitting the cost.
- A coinsurance split after the deductible.
- An out-of-pocket maximum for the year, after which the plan covers more or all.
- An authorization step for intensive outpatient and PHP-intensity hour expansion, which we handle.
What we do for you on the benefits side
- Call Florida Blue on the back of your card and pull the actual out-of-network behavioral numbers for the level of care you need.
- Translate them into the dollar cost of a week of treatment, so there are no surprises.
- Submit the authorization and stay on the case through review and renewal.
- Bill what the plan considers reasonable, so there is no balance-bill surprise later.
If you winter in Florida and your home plan is up north.
A large share of Florida's seasonal population carries a home plan from Pennsylvania, Minnesota, the upper Midwest, or the Northeast, and spends the cold months in the sun belt. The Blue Cross and Blue Shield system uses the BlueCard program to process claims across state lines, but the network status of any specific provider in Florida depends on your home plan. When you need behavioral health care while you are away from your home network, the question is what your home plan pays on an out-of-network basis. Virtual care sidesteps the geography entirely, because you attend from wherever you are physically located, as long as that is a state where the clinical team is licensed to treat.
The standard OON behavioral benefit
Most Florida Blue BlueOptions PPO plans include an out-of-network behavioral health benefit with a separate OON deductible and a coinsurance split after that. HMO products usually do not pay out of network. We pull yours before you commit.
Start the benefit check Home plan from another stateBlueCard and away-from-home care
If your card says Blue Cross Blue Shield from Pennsylvania, Minnesota, Illinois, or another state and you are in Florida for the season, your home plan controls your out-of-network behavioral benefit. We read your home plan, not the Florida brochure. Send us the front of your card and we will tell you what travels with you.
Start the benefit checkYou attend from where you are physically located.
Telehealth licensure follows the state where the patient is physically located during the session. Our clinical team is licensed in California, and we treat patients who are physically in California during their sessions. If your situation involves another state, we will tell you honestly on the first call whether we are the right fit or whether we should help you find a licensed provider in your location.
Plain-English answers.
Are you in network with Florida Blue or BCBS Florida?
No, we are out of network with Florida Blue and with commercial carriers generally. In-network credentialing is in progress. Many Florida Blue BlueOptions PPO plans include an out-of-network behavioral health benefit, and we bill out-of-network.
I spend winters in Florida but my plan is from another state. Which plan pays?
Your home plan controls your out-of-network behavioral benefit, even while you are in Florida. The Blue Cross Blue Shield BlueCard program processes the claim across state lines, but the terms come from the plan that issued your card. Send us the front of your card and we will read your specific plan, not a Florida brochure.
Does it matter if my plan is an HMO or a PPO?
Yes. Florida Blue PPO products such as BlueOptions usually include an out-of-network behavioral benefit. HMO products such as BlueCare usually do not pay out of network except in an emergency. We confirm which kind you have and what it covers before you commit.
How do I find out what my plan really covers?
Send us the member ID and group number on the front of your card. We call the plan, pull the actual out-of-network behavioral numbers for the level of care you need, and translate them into what a typical week of treatment would cost you, before you start.
Will my employer find out?
No. Substance use treatment records are protected under 42 CFR Part 2. We do not release any information to your employer without your written consent. The exception is if the law requires it or if your safety is at risk.
How fast can I start?
Typically same or next business day for the clinical assessment, and within the same business week for program start, once benefits and authorization are confirmed.
Verify your benefits in two minutes.
Send us the member ID and group number on the front of your card. We come back with your specific out-of-network deductible, coinsurance, out-of-pocket maximum, and what a typical week of intensive outpatient or partial hospitalization-intensity care would cost you. No commitment until you decide.
If you or someone you are with is in immediate danger, call or text 988 (the Suicide & Crisis Lifeline) or call 911. Shift Support Network is an outpatient program and is not an emergency service. Substance use treatment records are protected by 42 CFR Part 2.