General Benefits

In-Network Benefits	Out-of-Network Benefits
Select Blue Advantage Series III pays 85 percent and the policyholder pays 15 percent of covered expenses after the deductible has been met.	Select Blue Advantage Series III pays 75 percent and the policyholder pays 25 percent of covered expenses after the deductible has been met.
$25 office visit copay includes same day lab and X-ray, up to annual max of $750 - annual maximum per person, then subject to deductibles and coinsurance.	Physician office visits subject to deductible and coinsurance.
Network providers will precertify medical care.	Policyholders must precertify hospital admissions and certain services.
There are usually no claim forms to file.	Policyholders may have to submit claims for reimbursement.