Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader, Important Information About MedicarePlans. endstream 0000059965 00000 n
Simply Blue. Learn more about your Blue Cross Blue Shield of Michigan plan options. 0000004500 00000 n
To request your QHC confirmation letter: Log in to your member account. *Note: MSPTA-represented (T01) employees, DROP employees, and Other Eligible Adult Individuals (OEAIs) and their dependents are not eligible for this benefit. Physician Qualification Form (PDF) Healthy Blue Achieve Form Co-insurance is a percentage of the cost you share with the plan. Under the new law, youll no longer be required to purchase unlimited personal injury protection (or PIP) if you have a certain level of health insurance coverage. No-fault auto insurance changes in Michigan bcbsm.com Health (6 days ago) WebThere are several ways you can request a QHC letter. (5 days ago) WebTo request a proof of qualified health coverage letter, contact Blue Cross' Customer Service department at 1-800-422-9146 from 8:30 a.m. to 5 p.m. Eastern time, Monday https://hwnr.bcbsm.com/content/dam/microsites/mpsers/2020/best-of-health-summer-nonmedicare.pdf Category: Health Show Health Filter Type: Treatment Create an account now. Please review directory information to ensure its accuracy before attesting. For the best experience, use the latest version of Google Chrome or Microsoft Edge. xref
GradCare Member Reimbursement Form U-M Premier Care Member Reimbursement Form 0000034485 00000 n
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Identified standard preventive services are covered at 100%, but most other services have a 20% in-network coinsurance after meeting the deductible. The best part is an HSA offers a triple tax advantage, payroll contributions, interest earned on investments and withdrawals for qualified medical expenses are all tax free. The HSA Plus Plan requires a monthly contribution that's different depending on whether the plan will cover you, you and your spouse, you and your children, or your entire family. endobj 0000049042 00000 n
An HMO provides necessary hospital and medical treatment when you are sick or injured, prescription medicine services, substance abuse treatment, short-term mental health care, and routine preventive health maintenance services such as immunizations. 0000042215 00000 n
Visit myfordbenefits.com and make your plan selection for 2023. 0000023941 00000 n
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Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health 0000016284 00000 n
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Please provide the following information about the policy holder of the other health coverage. 0000026478 00000 n
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Those costs include increased copay and deductible amounts. An important note regarding the State Health Plan PPO deductibles: You have the freedom to see both in-network and out-of-network providers. Access tools to prescreen, submit and check the status of submitted claims. We can help. 0000016573 00000 n
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Employees selecting the HSA Plan are responsible for a fixed amount copayment of $200 for each visit to the emergency room after your deductible has been met. The Plan also covers most of your community-based care (office visits), as well as necessary medical equipment and supplies (crutches, hearing aids, etc.). 0000019892 00000 n
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And that both plans include a health savings account or HSA, that allows you to set aside tax-free funds that you can use for qualified medical expenses. 0rtq]%g=z.#i0\*m(D2q;t2}$kX[-+G-0hdA9r*8!jcsfEdRyV0=bLzf']q[6F"h.wB)^wvDH
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f'e$GVi]G}//xTw)9]y(kkxU*uXT) 0ajx[k jK`8P1(GU=. If you choose to do so, you will be responsible for both deductibles. Because Mary's cost to have the HSA Plan is $0, her total cost is $3,030. California Physicians Service DBA Blue Shield of California 1999-2023. 0000059434 00000 n
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In order to understand if youll need information from Blue Cross to make an auto coverage decision, youll want to first talk to your auto insurer. To find the most up-to-date information about current medical and pharmacy claims, you can use the Blue Cross app or log into your BCBSM member account at bcbsm.com. Enrollment in the State HDHP will also provide access to an HSA, which is a tax-advantaged savings account that can be used to pay onlyeligiblehealth, prescription, dental, and vision-related expenses incurred for services not covered by insurance (e.g., deductibles, copays, and coinsurance). Log in now myfordbenefits.com HELPS YOU: View personalized benefits b|=b}#Aif3TRD0;@NHkQ#`VEQxD trailer
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Enter the three letters of your "Enrollee ID" found on your Blue Cross Blue Shield member ID card, and then click Go. lC]n8\! You must be in pay status to receive this payment. For example: a single person chooses an in-network hospital for surgery. 0000007628 00000 n
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In 2021, you'll have a choice between two HSA eligible medical plans, HSA Plan and HSA Plus Plan. Once logged in, navigate to the QHC letter in the Proof of Insurance section at the bottom of the page. If your spouse's (non-State) employer will not cover you under their group plan because you are enrolled in any of the State-sponsored health care options,you can "opt out" completely and still receive the $50 biweekly payment (select "Health Waiver with Rebate"). Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. endobj 120 0 obj 0000014991 00000 n
He paid the full $800 cost of his medical services because the cost is less than the deductible for either plan. Share & Bookmark, Press Enter to show all options, press Tab go to next option, Retirement and Deferred Compensation Board, Upcoming Individual Consultations & Seminars, Oakland County's Qualified Health Coverage Letter for Active Employees, Oakland County's Qualified Health Coverage Letter for Retiree, Notice of Qualified Health Coverage for Purposes of Michigan No-Fault Auto Law, 2023 PPO 1 Summary of Benefits and Coverage, 2023 PPO 3 Summary of Benefits and Coverage, Summary of Information for Preventive Care, 2023 PPO 2 Summary of Benefits and Coverage, 2023 Traditional Summary of Benefits and Coverage, 2023 HAP Summary of Benefits and Coverage, BCBSM Approved Autism Evaluation Centers and Behavioral Analysts. .r~'J ms-oA&@i 9k2 J4T{Yt;cu6J_Fs"6r|(Z? Blue Cross Blue Shield of Michigan: Understanding member ID cards 0000015249 00000 n
You still have the freedom to go out-of-network to see any physician, hospital or other provider of your choice. Effective January 1, 2023, MSPTA-represented (To1) employees are eligible for this benefit, DROP employees and OEAIs and the dependents remain ineligible. You can also review your current plan to help make the best choice for 2021. 0000029225 00000 n
Callers to our phone lines are currently experiencing long wait times. To get reimbursed for a flu or pneumonia shot, you'll need to fill out our Member Flu and Pneumonia Shots Reimbursement Form (PDF). When asked to log in, choose Continue as a guest. 0000017188 00000 n
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Under the new legislation, residents may select different levels of PIP coverage. 800-229-2210 General Inquiries. 0000020798 00000 n
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OptumRx is the Pharmacy Benefit Manager for the State Health Plan PPOand will administer all retail, mail-order, and specialty prescription services for active employees and both Medicare-eligible and non-Medicare eligible retirees. This tool provides side-by-side medical plan comparisons and personalized cost modeling. 0000005259 00000 n
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View the eGuide to see the Ford resources available all year long. 0000048916 00000 n
This contribution will be prorated for employees who enroll mid-year. 0000008905 00000 n
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$158 per month) Eligibility: All MSU students, Law students, Visiting scholars, and more, including spouse and children of a student enrolled in the plan. startxref Click continue to proceed with verification. Detroit, MI 48226-9942. a health reimbursement arrangement which helps members pay for qualified medical expenses. Individuals attempting unauthorized access will be prosecuted. An HSA is a smart way to save for your future qualified health expenses, including those that may come up in retirement.
Click My Plan and Spending. Plan: Blue Care Network (BCN) Premium Cost: Summer 5/16/20 - 8/15/20 $474.00 (approx. Or, call the number on the back of your member ID card. XYQ This product provides comprehensive PPO coverage with costsharing features. And for the HSA Plus Plan, it's $1,020. View detailed plan information in this document. For instance, you can make your own before tax paycheck contributions to your HSA, use the accelerated HSA contribution option to ensure savings are available sooner, or simply plan to pay yourself back later in the year once your HSA savings has time to build. Both plans include a health savings account HSA. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. 0000031415 00000 n
In accordance with state and federal law, contracted providers and facilities must attest to the accuracy of their directory information at least every 90 days. Please enable JavaScript in your browser for a better user experience. 0000060222 00000 n
248-524-0454 The deductible is the amount you pay before your plan contributes to your costs. To help you compare and select your 2021 medical plan, Ford has provided Benefits Mentor powered by IBM Watson Health. They are responsible for the out-of-network deductible. 0000035745 00000 n
If you don't have a Provider Connection account, you will need to register before logging in. 0000018771 00000 n
You can also opt-out if you qualify for that provision. "Qualified Health Coverage" means your health coverage: Does not exclude or limit coverage for motor vehicle accidents; and Has an annual deductible of $6,000.00 or less per covered individual. This copay does not apply to the out of pocket maximum for the HSA Plan, so Mary will be responsible for this copay each time she or a family member visits the ER, after the deductible is met. The state will make an annual HSA contribution of $750 for an eligible individual employee enrolled in the State HDHP or $1,500 for an eligible employee who enrolls with one or more eligible dependents in the State HDHP,* effective January 1. An HMO is a managed care plan that provides medical care through its network of physicians, pharmacies, contracted hospitals, and medical care suppliers. To obtain a coordination of benefits letter, call the number on the back of your Enrollee ID card. Telemedicine Benefit Summary:Telemedicine visits allow you to meet with a US board-certified doctor online using a video-chat tool. This tool provides side-by-side medical plan comparisons and personalized cost modeling. If you have any questions, call the phone number on the back of your Blue Cross ID card and we'll help. Verify eligibility of Blue Shield of California, Blue Shield of California Promise Health Plan, other Blue plan and Federal Employee Program members, and access associated benefits information. You can now file disputes, attach supporting documents, and retrieve letters for submitted disputes online! 0000010919 00000 n
Available for commercial, Shared Advantage, and BlueCard. If you are 55 or older, you can make an additional catch-up contribution of $1,000 per year until you are enrolled in Medicare. 0000025213 00000 n
It has more than 20,000 physicians, including specialists, and more than 140 all acute care hospitals in Michigan. Because the deductible for the HSA plan is higher, James is responsible for paying the full cost of his health care services, including his medications. SM. 0000029999 00000 n
Health Insurance Marketplace Check out information about the Marketplace, especially if you are not eligible for coverage through LCC. <> Michigans new auto no-fault insurance law went into effect July 1, 2020. To find the most up-to-date information about current medical and pharmacy claims, you can use the Blue Cross app or log into your BCBSM member account at bcbsm.com. When you combine Mary's cost to have and use the HSA Plus Plan, her total cost is $5,306. *Blue Shield of California member plans only. 0000034448 00000 n
The rule provides protection against balance or "surprise" billing under certain circumstances, and phases in new transparency requirements on most group health plans and health insurers. 0000051836 00000 n
Even though this law has to do with your auto insurance, a lot of people have questions about what it means for your. 0000031798 00000 n
They areresponsible for the deductible, then the hospital is reimbursed according to the plan design. 0000012767 00000 n
Members should direct specific questions about PIP coverage to their auto insurer. [Instructor] Hello, and welcome to Blue Cross Blue Shield of Michigan. Mary would pay nothing from her paycheck to have the HSA Plan. Depending the level of PIP you choose, your auto insurer may request a letter stating whether you have qualified health coverage, or QHC. For more info, visitwww.mi.gov/AutoInsurance, emailAutoInsurance@mi.gov, or call 833-ASK-DIFS (275-3437). 0000029515 00000 n
If your auto insurance is requesting a QHC letter to issue or renew a policy, you may request a QHC letter by contacting yourhealth carrier. 0000038624 00000 n
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These scenarios are simple, and there are many other ways you can consider managing your out-of-pocket costs with your health savings account. For all other claims, choose your health plan on this page to find the form and instructions for sending it in. With the HSA Plan, you pay 100% of medical and prescription costs until your deductible is met. 0000030241 00000 n
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The HSA Plan is still the less costly option for Mary because the total cost to have and use the plan is lower in the HSA Plan. Once logged in, navigate to the https://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/no-fault-changes.html What does PIP cover? 0000021168 00000 n
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New SHP PPO membership ID cards will be mailed in September 2019. 0000020133 00000 n
The document must: To help you compare and select your 2021 plan based on your personal needs, Ford has provided Benefits Mentor powered by IBM Watson Health. Select Claims on the menu bar. We'll accept a qualification form from an office visit that occurred up to 180 days before the start of your plan year. Here's how these plans work. Please refer to www.bcbsm.com/som for the list of providers. 1-313-225-9000. They won't charge you the difference between their normal charge and the amount paid by the State Health Plan PPO. You're now aware you have a choice between two HSA eligible medical plans in 2021. Your email address will not be published. Demographics |Electronic Data Interchange (EDI) | Recoveries, Need help with Provider Connection: Blue Shield Provider Connection Guide Provider Connection training. 0000027006 00000 n
The State High Deductible Health Plan (HDHP) with Health Savings Account (HSA) provides a different way for employees to cover health care costs while still being able to access the entire BCBSM PPO network. Each letter serves a distinct and specific purpose: Notice of qualified health coverage for auto personal injury protection (PIP) benefits: Changes to Michigan's no-fault auto insurance law that . Claims | Benefits | Member eligibility | How to use Provider Connection | Contracts | Credentialing | Employees can now get a Health Care Plan Verification letter through Wolverine Access by selecting Employee Self-Service > Benefits > Health Care Plan Verification. #G:&#WeKo]b287X]4 fd!n>X3jG[)GW%0.{1,JqA]Vf,fyf#Ji+OvDUpe!K|\"e2{g3ePW?/p We're making your EOB easier to understand. 163 0 obj
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When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. This means you have the option to increase your payroll contributions so you can reach the maximum contribution amount earlier in the year. The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. The only providers permitted to submit a signed "Hospital Coverage Letter" for hospital privileges' requirement, are the following provider specialties/types: Adolescent Medicine, Child & Adolescent Psychiatry, Developmental-Behavioral Pediatrics, Family Practice, General Practice, Geriatric Medicine, Internal Medicine, Pediatrics, Physical You can also take a closer look at your current plan to help you make the best choice for your 2021 plan. 500 Renaissance Center. This plan didn't cover prescription charges, office visit charges, medical equipment, psychiatric services, or other major medical services. Let's say Mary and her family have a normal year with normal doctor visits. You can keep your unlimited PIP coverage. Both plans offer the largest doctor and hospital network as well as benefits, including prescription drug coverage and in-network preventive care at no additional cost. You can choose your own primary care physician who will provide direct care or make referrals from within the network. 0000024839 00000 n
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Detroit, MI 48243. Current SHP PPO enrollees will be automatically transitioned with no gap or changes in coverage. For the HSA Plan, your deductible and out-of-pocket maximum amounts for in-network services are the same. 0000021696 00000 n
How to Recognize Signs and Ease the Burden, PEARS Increases Early Autism Identification in Toddlers with Play-Based, Rapid Interactive Screening System, Its My Duty: How Doctors are Working to Reduce Health Disparities Among Black Patients, Does not exclude or limit coverage for injuries related to motor vehicle accident and has an annual deductible of $6,000 or less per individual, Or if your coverage is Medicare Parts A & B. Standard Qualification Form If you have a Blue Cross Blue Shield of Michigan plan other than Healthy Blue Achieve that requires a qualification form, please use the form below. endstream
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And you don't have to use the money by the end of the year, your account balance will not expire. 159 0 obj
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The new Michigan No-Fault insurance law defines qualified health coverage in two ways: It is "health or accident coverage" that "does not exclude or limit coverage for injuries related to motor vehicle accidents" and its "annual deductible for coverage" must be "$6,000 or less per individual." (MCL 500.3107d (7) (b) (i)) Or it is Medicare coverage. If you need information about eligibility, benefits or claims, or want to submit or review an authorization, the best way to get up-to-date information is through our on-line resources. 0000041020 00000 n
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You can use the money if you leave the company, change your plan, or retire. State Health Plan PPO - Administered by Blue Cross Blue Shield of Michigan (BCBSM). 0000020507 00000 n
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PIP is the part of an auto insurance plan that covers the health care costs from a car . Try again later. And with the HSA Plus Plan, Ford will also contribute to your HSA. [Narrator] Hello again, and welcome to Blue Cross Blue Shield of Michigan. hb```5,|z cbD{600T|txGyG{T8"W3\baah4p1$$ v3Kx4@6@ 1
Healthcare includes your Medical (ASR, BCBS, or HAP), Prescription (Navitus or HAP), Dental (Delta Dental), and Vision (NVA). See your 2023 Benefits-at-a-Glance (PDF) for more plan details. Earnings on an HSA fund balance are tax-free, and you can withdraw your money tax-free anytime, as long as you use it for qualified medical expenses for yourself or your tax dependents. Employees can also make pre-tax HSA contributions by payroll deductions. %PDF-1.7
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This provides cost and other information related to your plan options. You may enroll in an authorized HMO plan serving your residential area. This amount does not count toward the plan's out-of-pocket maximum. %%EOF <>stream
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To request a proof of qualified health coverage letter, contact Blue Cross' Customer Service department at 1-800-422-9146from 8:30 a.m. to 5 p.m. Eastern time, Monday through Friday. Fax: 248-524-2752, https://dev.michigan.local/som/json?sc_device=json, State Health Plan Preferred Provider Organization (PPO), State High Deductible Health Plan (HDHP) with Health Savings Account (HSA), Catastrophic Benefits (Effective January 1, 2023 this plan is no longer available to employees and their dependents), OptumRx is the Pharmacy Benefit Manager for the State Health Plan PPOand will administer all retail, mail-order, and specialty, State High Deductible HealthPlan (HDHP) with, dministered by Blue Cross Blue Shield of Michigan (BCBSM),HSA a, The federal government issued the "transparency in coverage" final rule under the Federal No Surprises Act. These plans also allow you to set aside tax-free funds that you can use for qualified medical expenses. (tJ)Dpdd5* 7YG1}[X3C=Yvou*tdU`{NRGqZy3Cv{c.W+5gE|7?)z
This copay is waived if Mary or her family member is admitted as a result of the ER visit. i'
*eW TVxZOEhL5wV/yZP^',UP1ko}87M@p_[8Sq^R/ Under the plan documents section, click Michigan Auto Reform to request a letter be mailed to the subscriber's address. The account and money are yours. bcbsm.com. | _1S}9M{T=o9B^>.!a8Znpk9(6_ Representatives are available 8:00 a.m. to 5:00 p.m., Monday through Friday. Benefits under this plan were payable only after you had paid expenses equal to one month's basic salary (your deductible). 0000023020 00000 n
`+DO>|5%Nqdws=0y';L a66[OIe,%EqtRS&54Qvw"E$iu3:G+x+II^ UTT"9W!4XuYS6Ly}l&!2 This was a hospitalization-only plan intended as an option if you had coverage elsewhere (for example, through a spouse who works for another employer). 0000011869 00000 n
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Use the Find-a-Doctor tool to verify provider participation in one of our plan networks. As you can see, there are great benefits to having an HSA. 0000027161 00000 n
14. other health care coverage 16. other policy holder's last name 19. other policy holder's date of birth 17. other policy holder's first name 20. name of other health carrier 21. other carrier policy/group number 22. other carrier street address city state zip code 23. other employer name major medical 24. type of other health insurance . 0000032777 00000 n
You don't need to wait until your new plan year starts to see your doctor. A plan is considered QHC if coverage for motor vehicle accidents is not excluded and the annual deductible is $6,000 or less per covered individual. Health Trust For the HSA Plus Plan, her yearly contributions, which is her cost to have the plan would be $3,300. See below. More from MIBluesPerspectives.com: MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association, Blue Cross Helps Primary Care Practices Survive Pandemic, Blue Cross, Blue Care Network to Return $21M to Individual Plan Members, Increasing Access to Behavioral Health Care in the Face of COVID-19, Concussions: The Warning Signs You Need to Know, Are You the Default Parent? Your Benefit Guide State Health Plan PPO 3 Visit BCBSM Customer Service Center 232 S. Capitol Ave. Lansing, MI 48933 . If you're asked to provide your auto insurer with a QHC letter, you will either need to contact your health plan (like Blue Cross) or your employer to request the letter. Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health hm6?ZqJ!nv+E 0000030483 00000 n
This is the amount taken from your pay each month. You keep what you dont spend on medical expenses, even if you retire or leave state employment. Two letters confirming you have MESSA coverage that are often requested by your auto insurance carrier can be found in your MyMESSA member account. 0000059211 00000 n
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%%EOF
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Visit myfordbenefits.com and make your plan selection for 2023. }v".VrTAmk$NJ+
y{i-Y#gds7D 0000059656 00000 n
Be informed about all your Blue Cross plan has to offer. 0000032373 00000 n
Respond promptly to the carrier to complete the final phase of the enrollment process. 0000037572 00000 n
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Utilize the Insurance Planspage to review plan summaries or contact the HMO that interests you to request their benefit booklet. Contact your auto insurance agent with questions and to learn more about your options. {07
N_Bdk Providers and facilities that fail to comply will be suppressed from our directories. Later in the year, that same person needs an MRI and chooses an out-of-network provider. You also have an out of pocket maximum, that's the maximum amount you pay in deductibles and applicable co-insurance during one plan year. Pontiac, MI 48341. For Medicare Members: No-fault auto law changes Health (Just Now) WebThere are several ways you can request a QHC letter. hbbd```b``z"@$D2e5A$)e,H^0 hbbd``b`$WX@]@D0(, IH0@1% b Cu@\v d"3|` 0000027945 00000 n
You're eligible for an HSA if you enroll in the State HDHP and have no other non-HDHP health care coverage, including coverage through your spouse or any other person, and you are not claimed as a dependent on another persons tax return. PIP pays for services that health insurance may or may not cover. 0000011580 00000 n
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And he pay $2,280 annually to have the HSA Plus Plan. So when we consider the total cost to have and use the plans, the HSA Plus Plan is the less costly option. 0000004052 00000 n
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In the HSA Plus Plan, you're also responsible for all medical and prescription costs until your deductible is met. James wouldn't have to pay anything from his paycheck to have the HSA Plan. But, if you receive services from a provider not in the PPO network, you may be responsible for paying additional out-of-pocket costs. %%EOF
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Qualified Health Coverage Documents DIFS Bulletin 2020-01-INS advises health plans should develop a document that indicates whether a person's coverage is "qualified health coverage" or QHC for purposes of the new no-fault law. Visit, Go to Qualified Transportation Fringe Benefits (QTFB), Active Employee State Health Plan PPO BCBSM Plan Booklet, Retiree State Health Plan PPO With Medicare Booklet, Understanding HMO Insurance Premium Rates. 0000015914 00000 n
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Visit Federal No Surprises Act (michigan.gov)for more information. State and Federal Privacy laws prohibit unauthorized access to Member's private information. 0000022070 00000 n
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Don't have a member account? 0000008446 00000 n
For Medicare Members: No-fault auto law changes bcbsm.com Health (Just Now) WebThere are several ways you can request a QHC letter. Once they've been met, the plan generally pays the full amount of your in-network medical and prescription costs. ^0} SX
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Questions About Your Benefits? If you have additional BCBSM contracts, pleas e include this as other coverage. We provide health insurance in Michigan. 0000039800 00000 n
After the deductible and coinsurance are applied for the HSA Plus Plan, James will be responsible for $3,480. endobj 0000015623 00000 n
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45o` T@> $0,Tkpp9~#@="-toen7=u-J 3P6sO1v 0IA||$IRs3R6o'j*vU#;B!FL5O,hBtA7|$xVv)*09KTOM8Gh6CAIT,[*6a8 wz James has arthritis, so he needs to take a higher cost maintenance drug. Reviewplan materialscarefully to understand the advantages and risks associated with the plan.
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