When we look again at the total cost of having and using the plans, the HSA Plan is the lower cost option for John. Preventive care benefits are covered 100 percent when received from a TRUST PPO network provider. 500 Renaissance Center. 0000033132 00000 n So in this scenario, the total cost to have and use the plans makes the HSA Plan the less costly option for Mary and her family. This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. Please see below for further information. 0000005625 00000 n Let's start with Mary who selected a plan to cover her family. Let's say Mary and her family have a normal year with normal doctor visits. After your deductible is met, co-insurance applies to medical and prescription costs until your out-of-pocket maximum is met. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. 0000032373 00000 n Members should direct specific questions about PIP coverage to their auto insurer. 0 *Note: MSPTA-represented (T01) employees, DROP employees, and Other Eligible Adult Individuals (OEAIs) and their dependents are not eligible for this benefit. Once they've been met, the plan generally pays the full amount of your in-network medical and prescription costs. So when we consider the total cost to have and use the plans, the HSA Plus Plan is the less costly option. 0000005259 00000 n 13 0 obj <> endobj When you combine Mary's cost to have and use the HSA Plus Plan, her total cost is $5,306. 0000017479 00000 n 14. other health care coverage 16. other policy holder's last name 19. other policy holder's date of birth 17. other policy holder's first name 20. name of other health carrier 21. other carrier policy/group number 22. other carrier street address city state zip code 23. other employer name major medical 24. type of other health insurance . This tool provides side-by-side medical plan comparisons and personalized cost modeling. Effective October 1, 2019, Blue Cross Blue Shield of Michigan, in partnership with Lucet, will be replacing Magellan Health as the State Health Plan (SHP) PPO Behavioral Health/Substance Use Disorder carrier. lC]n8\! endstream 0000023020 00000 n 0000048916 00000 n This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. 0000015249 00000 n The out-of-pocket maximum does not include monthly paycheck contributions, copayments, or any expenses not covered by your plan. 0000017188 00000 n 141 0 obj 0000030725 00000 n Benefits under this plan were payable only after you had paid expenses equal to one month's basic salary (your deductible). Your Benefit Guide State Health Plan PPO 3 Visit BCBSM Customer Service Center 232 S. Capitol Ave. Lansing, MI 48933 . GradCare Member Reimbursement Form U-M Premier Care Member Reimbursement Form 0000022361 00000 n \8/$z To help you compare and select your 2021 plan based on your personal needs, Ford has provided Benefits Mentor powered by IBM Watson Health. 0000000016 00000 n MSU Student Health Insurance Plan. Log in now myfordbenefits.com HELPS YOU: View personalized benefits 0000027161 00000 n 600 Lafayette East. Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health You can also take a closer look at your current plan to help you make the best choice for your 2021 plan. 0000013426 00000 n `+DO>|5%Nqdws=0y';L a66[OIe,%EqtRS&54Qvw"E$iu3:G+x+II^ UTT"9W!4XuYS6Ly}l&!2 An HMO is a managed care plan that provides medical care through its network of physicians, pharmacies, contracted hospitals, and medical care suppliers. It can help treat minor illnesses such as colds, sinus or respiratory infections, sprains, or rashes, making it perfect when your primary care physician is unavailable or leaving the house is difficult. 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. Questions About Your Benefits? Blue Cross Blue Shield of Michigan, in partnership with Lucet Later in the year, that same person needs an MRI and chooses an out-of-network provider. 0000021457 00000 n 0 0000004937 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. <. Its important to know that in order to opt-out of PIP coverage under the new Michigan law, you must have health insurance that is considered qualified health coverage. Visit myfordbenefits.com and make your plan selection for 2023. Learnyour requirements, deadline dates and more about your coverage. If you absolutely need to call, please try again at a later date. Once logged in, navigate to the https://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/no-fault-changes.html Your co-insurance amount for in-network services is 20%. With the total of all her family services and prescriptions, the HSA Plan costs $3,030 to use. 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 plan covers inpatient hospital care, as well as other outpatient services received at a hospital including emergency room care. 0000048613 00000 n Thank you for viewing. 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. [Narrator] Hello again, and welcome to Blue Cross Blue Shield of Michigan. The deductible is the amount you pay before your plan contributes to your costs. Two letters confirming you have MESSA coverage that are often requested by your auto insurance carrier can be found in your MyMESSA member account. 193 0 obj <>stream In our next scenario, James covers his wife on his medical plan. This plan didn't cover prescription charges, office visit charges, medical equipment, psychiatric services, or other major medical services. See below. California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. 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. 0000048472 00000 n We can help. Access commonly requested forms for patient care activities, credentialing, and more. 0000006389 00000 n 0000048277 00000 n Telemedicine Benefit Summary:Telemedicine visits allow you to meet with a US board-certified doctor online using a video-chat tool. Demographics |Electronic Data Interchange (EDI) | Recoveries, Need help with Provider Connection: Blue Shield Provider Connection Guide Provider Connection training. startxref 0000059434 00000 n 0000013137 00000 n They won't charge you the difference between their normal charge and the amount paid by the State Health Plan PPO. endstream endobj 14 0 obj <. 0000026320 00000 n Other costs to use the HSA Plan will vary depending on whether you select plan coverage for you or for your family. <>stream This amount does not count toward the plan's out-of-pocket maximum. California Physicians Service DBA Blue Shield of California 1999-2023. 0000010919 00000 n Log in to get your questions answered by a live representative, Monday through Friday, 6 a.m. to 6:30 p.m. To get reimbursed for a flu or pneumonia shot, you'll need to fill out our Member Flu and Pneumonia Shots Reimbursement Form (PDF). TVxZOEhL5wV/yZP^',UP1ko}87M@p_[8Sq^R/ 0000024311 00000 n {07 N_Bdk The document must: Respond promptly to the carrier to complete the final phase of the enrollment process. 0000003914 00000 n 0000048834 00000 n The maximum deductible for two or more covered persons in your family was limited to 1 months of your basic salary. We provide health insurance in Michigan. 800-229-2210 db4H@g& C XYQ This product provides comprehensive PPO coverage with costsharing features. %%EOF Visit Federal No Surprises Act (michigan.gov)for more information. 163 0 obj <>stream This plan provides health benefits using providers and facilities that are in-network, meaning the providers and facilities have agreed to accept a discounted fee from BCBSM in order to be in-network. General Inquiries. 0000014041 00000 n 0000022731 00000 n 0000033229 00000 n b|=b}#Aif3TRD0;@NHkQ#`VEQxD 0000031112 00000 n Blue Shield/Blue Shield Promise network referrals. Log in to continue with member verification. Click continue to proceed with verification. These scenarios are simple, and there are many other ways you can consider managing your out-of-pocket costs with your health savings account. Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. 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. 0000036634 00000 n N'JV|DI]Ea:%*&[|{;z^HzwD/L_d?D/q|',W2tKpcukU;Bxc%w37XeNh{%_hl@zPMy * uAd;{i6pmn'D=6e Cvy"ngpdh6 s/8bG. When asked to log in, choose Continue as a guest. This contribution will be prorated for employees who enroll mid-year. 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. 0000049165 00000 n hbbd```b``z"@$D2e5A$)e,H^0 You can also review your current plan to help make the best choice for 2021. (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 0000027006 00000 n 0 You may enroll in an authorized HMO plan serving your residential area. 0000018397 00000 n The Plan also covers most of your community-based care (office visits), as well as necessary medical equipment and supplies (crutches, hearing aids, etc.). There are different levels of PIP coverage that you can choose from. 0000048976 00000 n Healthcare includes your Medical (ASR, BCBS, or HAP), Prescription (Navitus or HAP), Dental (Delta Dental), and Vision (NVA). The network covers all 83 Michigan counties and is the largest PPO network in Michigan. endstream endobj startxref 1996-2023 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. John's annual paycheck deduction for the HSA Plan is zero. And he pay $2,280 annually to have the HSA Plus Plan. SECTION 2 OTHER HEALTH COVERAGE INFORMATION . 0000008905 00000 n 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. <<674A7177E0417F4590EC384E93D00AED>]>> 0000018771 00000 n 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. What does PIP cover? These plans also allow you to set aside tax-free funds that you can use for qualified medical expenses. Look for the chat icon at the bottom right corner of the screenon any page of this website. In 2021, you'll have a choice between two HSA eligible medical plans, HSA Plan and HSA Plus Plan. View detailed plan information in this document. 0000005858 00000 n Representatives are available 8:00 a.m. to 5:00 p.m., Monday through Friday. 0000011580 00000 n 0000036168 00000 n The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. 0000037572 00000 n 0000019721 00000 n 606 0 obj <>stream 0000009647 00000 n Because Mary's cost to have the HSA Plan is $0, her total cost is $3,030. Available for commercial, Shared Advantage, and BlueCard. See your 2023 Benefits-at-a-Glance (PDF) for more plan details. The rule provides protection against balance or "surprise" billing under certain circumstances, and phases in new transparency requirements on most group health plans and health insurers. Identified standard preventive services are covered at 100%, but most other services have a 20% in-network coinsurance after meeting the deductible. 0000030483 00000 n You can call the number on the back of your member ID card. lo%x9d,oqM lzgw'TK6oB~+d; {qi.B/ R`]Hcq6~s_]=y&|9]Fl2b\o9Vp"(5Z9lb.dx;@? *Mii lkSW+0XI~'kT`C>?wlvR %PDF-1.6 % Find information about Promise Medi-Cal and Cal MediConnect, our policies, procedures and programs. 0000029999 00000 n 0000004500 00000 n To find the most up-to-date information about current medical and pharmacy claims, you can use the Blue Cross app or log into your BCBSM member account at bcbsm.com. 0000025504 00000 n Your auto insurer may also ask for a letter about how your health coverage coordinates with your auto insurance for auto accident medical claims (i.e., which coverage pays primary in an auto accident). Ready to enroll? Detroit, MI 48243. You can log in to your online member account to see if you have a QHC letter to download. hbbd``b`$WX@]@D0(, IH0@1% b Cu@\v d"3|` Please refer to www.bcbsm.com/som for the list of providers. 13 151 Create an account now. 0000028562 00000 n 0000007258 00000 n endstream 0000003382 00000 n This tool provides side-by-side medical plan comparisons and personalized cost modeling. Your explanation of benefits (EOB) statement has a new look. Provided in a vehicle qualified as an ambulance and part of a licensed ambulance operation Pontiac, MI 48341. .r~'J ms-oA&@i 9k2 J4T{Yt;cu6J_Fs"6r|(Z? Use the Find-a-Doctor tool to verify provider participation in one of our plan networks. We're making your EOB easier to understand. 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. endstream endobj startxref New SHP PPO membership ID cards will be mailed in September 2019. 0000006680 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. <> 0000023941 00000 n You must be in pay status to receive this payment. Blue Cross Blue Shield of Michigan. If your no-fault insurance carrier requests or requires confirmation of your university health plan's position for coordination with no fault, please call the SSC Contact Center at 734-615-2000 or 1-866-647-7657 (toll free). 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). hb``a`` -mY8PE!u[dCC#W6,j.Fvtl,s fb`p;CT3j Effective January 1, 2023, MSPTA-represented (To1) employees are eligible for this benefit, DROP employees and OEAIs and the dependents remain ineligible. 0000016284 00000 n You may look up HMOs in your residential area using the zip code tool. To quickly and easily find out if you, the provider, or a provider referral, participate in the member's plan network*, either log in or register for Provider Connection. hm6?ZqJ!nv+E 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. 0000012476 00000 n Qualified Transportation Fringe Benefits (QTFB). 0000004148 00000 n An important note regarding the State Health Plan PPO deductibles: You have the freedom to see both in-network and out-of-network providers. 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. 0000014991 00000 n 119 0 obj 0000008045 00000 n 0000026163 00000 n 0000059965 00000 n 0000010545 00000 n 0000027316 00000 n 159 0 obj <>/Filter/FlateDecode/ID[<38505CF35D4D814CB849C61D42F0BD2C>]/Index[140 54]/Info 139 0 R/Length 99/Prev 142241/Root 141 0 R/Size 194/Type/XRef/W[1 3 1]>>stream 0000048683 00000 n After that deductible is met, out-of-network charges are paid according to the plan design. The State Health Plan PPO provides reimbursement for medical care expenses when you need treatment for an illness, injury, or disease. For example: a single person chooses an in-network hospital for surgery. 0000051836 00000 n 0000016814 00000 n Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader, Important Information About MedicarePlans. First, let's look at the cost to have a medical plan. Health Insurance Marketplace Check out information about the Marketplace, especially if you are not eligible for coverage through LCC. PIP pays for services that health insurance may or may not cover. If your auto insurance is requesting a QHC letter to issue or renew a policy, you may request a QHC letter by contacting your health carrier. 0000020133 00000 n State-sponsored health insurance carriers are prepared to send a letter to State employees or retirees, upon request, confirming their health plan is considered Qualified Health Coverage (QHC). Or, call the number on the back of your member ID card. We're redirecting you to Blue Shield of California's Find a doctor search. 0000014702 00000 n i' *eW endstream endobj 141 0 obj <>/Metadata 11 0 R/Pages 138 0 R/StructTreeRoot 21 0 R/Type/Catalog/ViewerPreferences 160 0 R>> endobj 142 0 obj <>/MediaBox[0 0 612 792]/Parent 138 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 143 0 obj <>stream $"mY_%Be66y=\"QI Uses standard Blue Cross ID card. a health reimbursement arrangement which helps members pay for qualified medical expenses. %PDF-1.6 % [Instructor] Hello, and welcome to Blue Cross Blue Shield of Michigan. The network covers all 83 Michigan counties and is the largest PPO network in Michigan. This means you have the option to increase your payroll contributions so you can reach the maximum contribution amount earlier in the year. HSA Plan and HSA Plus Plan. *Except for those employees in certain bargaining units who are hired on or after 1/1/00 who have a regular work schedule of 40 hours or less per bi-weekly pay period (not permanent-intermittent positions). trailer hb```5,|z cbD{600T|txGyG{T8"W3\baah4p1$$ v3Kx4@6@ 1 The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. 0000026478 00000 n 0000020507 00000 n State and Federal Privacy laws prohibit unauthorized access to Member's private information. 0000012767 00000 n 0000008674 00000 n Field Service. Be informed about all your Blue Cross plan has to offer. 0000029515 00000 n 0000010306 00000 n Members enrolled in the HSA plan will be responsible for paying an ER copayment after the deductible has been met. 0rtq]%g=z.#i0\*m(D2q;t2}$kX[-+G-0hdA9r*8!jcsfEdRyV0=bLzf']q[6F"h.wB)^wvDH =/OC; f'e$GVi]G}//xTw)9]y(kkxU*uXT) 0ajx[k jK`8P1(GU=. When an out-of-area Blue plan member seeks medical care from your office, use our tools to simplify claims submission to BlueShield of California. Give us a call to discuss your plan options. State Health Plan PPO - Administered by Blue Cross Blue Shield of Michigan (BCBSM). It has a deductible of $6,000 or less per person. Enter the three letters of your "Enrollee ID" found on your Blue Cross Blue Shield member ID card, and then click Go. Since John has individual coverage, he gets a $500 HSA contribution from Ford if he selects the HSA Plus Plan, Ford doesn't make a contribution towards the health savings account for the HSA Plan. You still have the freedom to go out-of-network to see any physician, hospital or other provider of your choice. Mary would pay nothing from her paycheck to have the HSA Plan. PIP coverage can include items like attendant care, housing modifications and lost wages. 0000016573 00000 n They areresponsible for the deductible, then the hospital is reimbursed according to the plan design. 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. What's qualified health coverage under the new law? 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. 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. For the HSA Plan, your deductible and out-of-pocket maximum amounts for in-network services are the same. For all other claims, choose your health plan on this page to find the form and instructions for sending it in. Thank you for viewing. Michigans new auto no-fault insurance law went into effect July 1, 2020. 0000014332 00000 n If you are new to an HMO, that HMO may ask you to select your primary care physician. 0000032777 00000 n 0000059656 00000 n Under the new legislation, residents may select different levels of PIP coverage. 0000058981 00000 n 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. 866-503-3158 (tJ)Dpdd5* 7YG1}[X3C=Yvou*tdU`{NRGqZy3Cv{c.W+5gE|7?)z For the HSA Plus Plan, her yearly contributions, which is her cost to have the plan would be $3,300. Your coverage is considered qualified if it: When making a decision, keep in mind that PIP has coverage that goes beyond traditional health insurance. 0000060222 00000 n Here's how these plans work. 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. You're now aware you have a choice between two HSA eligible medical plans in 2021. 373 0 obj <>stream 0000048409 00000 n Employees can now get a Health Care Plan Verification letter through Wolverine Access by selecting Employee Self-Service > Benefits > Health Care Plan Verification. ATTENTION: To ensure individuals with disabilities have an equal opportunity to access enrollment services for Qualified Health Plans, if you have a disability (such as visual or hearing impairment) auxiliary aids and alternative formats are available free of charge by contacting HealthCare.gov or calling 1-800-318-2596 to speak with HealthCare.gov. For the HSA Plus Plan because Mary met her deductible and a portion of her service costs are paid at the 20% co-insurance, she would be responsible for $3,006 out of pocket to use this plan. Health insurance plans may contain auto exclusions (meaning they don't provide coverage for car accident-related injuries); may fail to cover the treatment, care and services needed by car accident victims; may limit such treatment, care and services in ways that No-Fault does not; and/or may involve managed care or HMOs which require Submit and confirm authorizations and approval of medical and pharmacy services prior to services being rendered. Both plans include a health savings account HSA. To help your savings grow even more, when your HSA balance reaches $1,000, you can choose a variety of investments. Learn about our tools and how to use them in our upcoming webinars. 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. No-fault auto insurance changes in Michigan bcbsm.com Health (6 days ago) WebThere are several ways you can request a QHC letter. &yw}.$7eIw 0000021696 00000 n Contact your auto insurance agent with questions and to learn more about your options. Contact your HR Benefits Team at LCC-HR-Benefits@star.lcc.edu Contact Human Resources Phone: 517-483-1870 Fax: 517-483-1883 Monday - Friday: 8:00 a.m. - 5:00 p.m. Administration Building 0000007628 00000 n To obtain a coordination of benefits letter, call the number on the back of your Enrollee ID card. Contact your auto insurance carrier for specific questions regarding PIP coverage. 0000043394 00000 n 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. %%EOF %PDF-1.7 % 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. 0000047030 00000 n Providers and facilities that fail to comply will be suppressed from our directories. Reviewplan materialscarefully to understand the advantages and risks associated with the plan. You don't need to wait until your new plan year starts to see your doctor. To request your QHC confirmation letter: Log in to your member account. 0000019432 00000 n 0000041020 00000 n 0000017849 00000 n 0000022070 00000 n 172 0 obj 0000027783 00000 n
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