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. Pontiac, MI 48341. 0000022731 00000 n 0000048207 00000 n 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. NO - YES - Please complete entire form, sign at the bottom and return sign at the bottom and return . %PDF-1.6 % The State Health Plan PPO provides reimbursement for medical care expenses when you need treatment for an illness, injury, or disease. 0000019432 00000 n 0000032373 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. %PDF-1.6 % Healthcare includes your Medical (ASR, BCBS, or HAP), Prescription (Navitus or HAP), Dental (Delta Dental), and Vision (NVA). Your explanation of benefits (EOB) statement has a new look. What's qualified health coverage under the new law? Access commonly requested forms for patient care activities, credentialing, and more. When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. 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. 0000014332 00000 n To help you compare and select your 2021 medical plan, Ford has provided Benefits Mentor powered by IBM Watson Health. Identified standard preventive services are covered at 100%, but most other services have a 20% in-network coinsurance after meeting the deductible. Qualified Health Coverage & Michigan No-Fault Insurance endstream endobj 14 0 obj <. 0000030725 00000 n PDF State of Michigan The Plan also covers most of your community-based care (office visits), as well as necessary medical equipment and supplies (crutches, hearing aids, etc.). 0000048409 00000 n 0000030483 00000 n (tJ)Dpdd5* 7YG1}[X3C=Yvou*tdU`{NRGqZy3Cv{c.W+5gE|7?)z 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. 0000009279 00000 n Mail Code 1112. Effective January 1, 2023, MSPTA-represented (To1) employees are eligible for this benefit, DROP employees and OEAIs and the dependents remain ineligible. You are encouraged to visit your benefit providers' website and create free member logins. You can keep your unlimited PIP coverage. Behavior Health/Substance Use Disorder Administrator. MSU Student Health Insurance Plan. %%EOF 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. View the Telemedicine Benefit Summary to see your State-sponsored health insurance carrier's telemedicine coverage. 0000060222 00000 n 0000028854 00000 n 0000024311 00000 n (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 0000016284 00000 n Physician Qualification Form (PDF) Healthy Blue Achieve Form Provider Connection Home | Blue Shield of CA Provider 13 0 obj <> endobj ^0} SX XD00{03pi`p. Uses standard Blue Cross ID card. 0000021168 00000 n All rights reserved. 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. Health Insurance Marketplace Check out information about the Marketplace, especially if you are not eligible for coverage through LCC. He paid the full $800 cost of his medical services because the cost is less than the deductible for either plan. SECTION 2 OTHER HEALTH COVERAGE INFORMATION . 0000005858 00000 n This plan didn't cover prescription charges, office visit charges, medical equipment, psychiatric services, or other major medical services. 0000049102 00000 n 0000032777 00000 n 0000048834 00000 n hb```5,|z cbD{600T|txGyG{T8"W3\baah4p1$$ v3Kx4@6@ 1 Need new coverage? Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health Learn more about your Blue Cross Blue Shield of Michigan plan options. This provides cost and other information related to your plan options. To request your QHC confirmation letter: Log in to your member account. 0000004052 00000 n 0000029757 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. lo%x9d,oqM lzgw'TK6oB~+d; {qi.B/ R`]Hcq6~s_]=y&|9]Fl2b\o9Vp"(5Z9lb.dx;@? *Mii lkSW+0XI~'kT`C>?wlvR View the eGuide to see the Ford resources available all year long. 0000037572 00000 n Those costs include increased copay and deductible amounts. What to Know About Changes to Michigan's Car Insurance Law For example: a single person chooses an in-network hospital for surgery. 0000003382 00000 n #G:&#WeKo]b287X]4 fd!n>X3jG[)GW%0.{1,JqA]Vf,fyf#Ji+OvDUpe!K|\"e2{g3ePW?/p Detroit, MI 48243. 0000035745 00000 n A QHC letter must contain the following: The full names and dates of birth of all individuals covered under the policy or plan; and A statement that includes whether the coverage provided constitutes "Qualified Health Coverage" as defined in MCL 500.3107d (7) (b) (i), or that the coverage: Does not exclude coverage for motor vehicle accidents, and Utilize the Insurance Planspage to review plan summaries or contact the HMO that interests you to request their benefit booklet. 0000014041 00000 n You're now aware you have a choice between two HSA eligible medical plans in 2021. 0000020133 00000 n [Instructor] Hello, and welcome to Blue Cross Blue Shield of Michigan. Enroll when you're ready. Log in to continue with member verification. 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. 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. 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. If you have additional BCBSM contracts, pleas e include this as other coverage. Your email address will not be published. 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. Click continue to proceed with verification. 0000023276 00000 n 0000059656 00000 n Thank you for viewing. 310 0 obj <>/Filter/FlateDecode/ID[<4C51D19B138643B1A2CB07133610D1D7>]/Index[258 116]/Info 257 0 R/Length 203/Prev 1461330/Root 259 0 R/Size 374/Type/XRef/W[1 3 1]>>stream 500 Renaissance Center. You may look up HMOs in your residential area using the zip code tool. 0000008674 00000 n This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. i' *eW The deductible is the amount you pay before your plan contributes to your costs. Members enrolled in the HSA plan will be responsible for paying an ER copayment after the deductible has been met. 140 0 obj <> endobj Links to all provider websites can be found on our Benefit Carrier Contact Information page. 0000039800 00000 n Simply . %%EOF "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. When asked to log in, choose Continue as a guest. Health Plan Details 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. With the HSA Plan, you pay 100% of medical and prescription costs until your deductible is met. The maximum deductible for two or more covered persons in your family was limited to 1 months of your basic salary. %PDF-1.6 % 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. 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. 0000028562 00000 n 248-524-0454 Provided in a vehicle qualified as an ambulance and part of a licensed ambulance operation Submit and confirm authorizations and approval of medical and pharmacy services prior to services being rendered. It has more than 20,000 physicians, including specialists, and more than 140 all acute care hospitals in Michigan. 0000013426 00000 n We're redirecting you to Blue Shield of California's Find a doctor search. 0000011580 00000 n 0000007628 00000 n Please provide the following information about the policy holder of the other health coverage. PIP pays for services that health insurance may or may not cover. 0000027161 00000 n 0000022361 00000 n 0000011869 00000 n 0000030241 00000 n 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. Before you select a medical plan, consider your total costs, including the costs to have and use the plan. Federal No Surprises Act: The federal government issued the "transparency in coverage" final rule under the Federal No Surprises Act.

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