Five common questions about medical Centers of Excellence
March 13, 2020
If you have a serious surgery coming up, using a Center of Excellence may improve your outcome — and even save you money if you have medical coverage through the Board of Pensions.
Centers of Excellence deliver superior results for complicated, costly surgical procedures, And, if you have medical coverage* through the Board of Pensions, your coverage includes several high-value features, including Centers of Excellence specialty benefits for certain surgical procedures.
Not sure what a Center of Excellence is or how using one can benefit you? Here are answers to five common questions about Centers of Excellence.
What is a Center of Excellence? Centers of Excellence are hospitals, providers, or groups that meet overall quality measures for patient safety and outcomes. Centers of Excellence focus on promoting best practices related to a specific health condition, such as cancer; cardiac care; bariatric surgery; transplants; knee and hip replacements; maternity care; and spinal surgery, so the Center of Excellence designation helps you identify facilities that offer the highest quality care for a particular condition.
Why should I use a Center of Excellence? In addition to receiving expert care, patients treated at Centers of Excellence have better outcomes, fewer complications, and fewer readmissions.
If I use a Center of Excellence, how much will my medical benefits pay? If you’re enrolled in the PPO, EPO, or HDHP option, your coverage includes an enhanced benefit when using Centers of Excellence providers for bariatric surgery; transplants; knee and hip replacements; and spinal surgery. When you (or your covered family members) have select procedures in one of these four areas performed at a Center of Excellence, the Medical Plan will pay 100 percent of allowable charges after you pay the annual plan deductible.
How do I find a Center of Excellence? Log on to your service provider’s website to find Centers of Excellence:
If you use the national Blue Cross Blue Shield network – Centers of Excellence are designated as Blue Distinction Centers and Blue Distinction Centers +. Use the provider search tool on the Highmark website to find providers with these designations. From the homepage, click on Find a Doctor or Pharmacy and select Find a Doctor, Hospital or other Medical Provider; then scroll down, click on Blue Distinction Centers under Find Quality Care, and search by desired specialty and state. Or, call the number on the back of your medical ID card.
If you use the Aetna network – Centers of Excellence are designated as Aetna Institutes of Quality (bariatric surgery, knee and hip replacements, and spinal surgery) and Aetna Institutes of Excellence (transplants). To find facilities with these designations, call the number on the back of your medical ID card, or visit the Aetna website to use the provider search tool.
What if there are no Centers of Excellence near me? If you have to travel more than 100 miles to a Center of Excellence, you are eligible for a travel benefit of up to $10,000* to cover expenses for yourself and a companion.
*These benefits are not available to members enrolled in Triple-S, GeoBlue, or the Medicare Supplement Plan.