Michigan State University has several Blue Care Network health plans with unique referral requirements. These referral requirements are described here. For more information, download the MSU Student and Graduate Assistant Health Plans flier (PDF) or see the Member Benefits chapter of the BCN Provider Manual. Here's how to find it:
- Log in as a provider at bcbsm.com.
- Click on BCN Provider Publications and Resources.
- Click on Provider Manual.
MSU Graduate Assistant Health Plan and MSU Student Health Plan
These plans cover graduate assistants and students at Michigan State University who do not have other health coverage.
|Behavioral health services:|
|These products follow standard BCN network and authorization rules for behavioral health.|
|Follow these steps to determine the provider's referral requirements:|
|First, determine if the provider is in the MSU Student Health Services Network, a unique network of BCN providers primarily in Michigan's Mid region. While providers in this network are predominantly located within 45 miles of Olin Health Center in East Lansing, participation in the network is based on the primary address associated with the provider group. The best way to determine network participation is to check the provider's status on our online provider directory. Here's how:|
|1.||Go to bcbsm.com/find-a-doctor.|
|2.||Click GET STARTED.|
|3.||Under Choose a health plan, type the provider's last name, followed by first name in the field marked Search for a doctor, hospital name or specialty. Click on the provider's name when it appears in the dropdown and then click Search.|
|4.||Results are displayed with the best match at the top. Click on the correct provider's name.|
|5.||If the primary location displayed is the correct location, click on the link to the Plans Accepted or select another location on the right side of the page and click Show info and then click on the Plans Accepted at that location.|
|6.||Look under Employer Group Plans, HMO Plans, Michigan State University Graduate Assistant and Student Health Plans.
|Once network status is known:
See the applicable referral guidelines in the chart below. All BCN plan notification and authorization requirements continue to apply regardless of the provider's network status.
All BCN plan notification and authorization requirements continue to apply regardless of the provider's network status.
|Provider location||Referral requirements|
|Olin Health Center||Referrals do not need to be submitted to BCN.|
|BCN providers who are part of the MSU Student Health Services Network (a network of providers predominantly located within 45 miles of Olin Health Center)||Referrals do need to be submitted to BCN for the following:
|Providers who are not part of the MSU Student Health Services network||A referral from the member's primary care physician is not required. The member can self-refer to any provider in Michigan.|
Michigan State University plan
This plan covers MSU employees who do not have Medicare as their primary coverage.
The Michigan State University plan does not require referrals or plan notification in order to process and pay claims, but some services require authorization regardless of whether they are performed at the in-network or out-of-network benefit level. Some preventive services, such as physical exams and immunizations, are only covered when provided in network.
Refer to the Blue Care Network Referral and Clinical Review Program (PDF) for information about which services require authorization. This document is available on the Clinical Review & Criteria Charts page on this website.
MSU Plan 65 (for MSU employees and retirees)
This plan covers MSU employees and retirees who have Medicare as their primary coverage. Referrals and plan notification are not required for claims payment for members with this coverage. Also, no authorizations are required, except for:
- Home infusion services not covered by Medicare
- Inpatient care when Medicare days are exhausted