We offer individual Exclusive Provider Organization (EPO) plans to residents in Alabama. The content on this page is specifically for the statewide EPO plans.

Use our EPO – Statewide Quick Reference Guide for Providers for assistance in caring for patients with the statewide plans.

Note: We also offer EPO plans for the Birmingham Metropolitan Statistical Area (MSA) that includes Jefferson, Shelby, Walker, Chilton, Blount, Bibb and St. Clair counties. Review a comparison of the EPO plans to see the differences between them.

Important Statewide EPO Plan Requirements for Coverage

• The statewide EPO plans only have coverage for in-network physicians and hospitals in Alabama, excluding accidental injuries/medical emergencies.
• Information About Contiguous Counties: Select providers in contiguous counties are allowed to process in-network for services provided.
  • Out-of-state providers for services such as labs, DME, specialty drugs and home infusion process as in-network. Planned hospital admissions are only allowed in Alabama hospitals.
  • Out-of-state and out-of-network hospitals can only be used for accidental injuries or medical emergencies.
• Statewide EPO plans require members to designate a primary care provider from the Primary Care Select Physician Network prior to receiving medical coverage.
• An electronic referral from the patient’s designated PCP is required before services performed by other providers are covered. Review our How to Submit, Review and Cancel Referrals guide for more information.

How to Identify Select Primary Care Providers

It’s important to check that a provider is in the Select Primary Care Network to ensure coverage for your patients with statewide EPO plans. 

To check the Select status of a specific provider, use our Find a Doctor tool (see below) by selecting Primary Care Select Physician from the “All Networks/Plans” drop-down menu.

How to Identify Your Patients With Statewide EPO Plans

• The Blue Statewide Silver EPO or the Blue Standardized Statewide Silver EPO name appears on patients’ Blue Cross and Blue Shield of Alabama cards.

 

You can also identify members of this network by checking Eligibility and Benefits, as shown below.