bcbsm qualified health coverage letter

Preventive care benefits are covered 100 percent when received from a TRUST PPO network provider. PPO. 0000028187 00000 n With the total of all her family services and prescriptions, the HSA Plan costs $3,030 to use. 0000048277 00000 n a health reimbursement arrangement which helps members pay for qualified medical expenses. .r~'J ms-oA&@i 9k2 J4T{Yt;cu6J_Fs"6r|(Z? But, if you receive services from a provider not in the PPO network, you may be responsible for paying additional out-of-pocket costs. 0000021168 00000 n Your coverage is considered qualified if it: When making a decision, keep in mind that PIP has coverage that goes beyond traditional health insurance. And with the $1,000 Ford contribution to his health savings account, James out of pocket costs to use the HSA Plus Plan is reduced to $2,480. Let's start with Mary who selected a plan to cover her family. 0000048349 00000 n 13 0 obj <> endobj 0000035230 00000 n Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader, Important Information About MedicarePlans. 0000013667 00000 n lC]n8\! endstream endobj 14 0 obj <. View detailed plan information in this document. The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. After that deductible is met, out-of-network charges are paid according to the plan design. Now let's imagine Mary and her family had a year with a lot of medical and prescription expenses where they meet the out-of-pocket maximum for both plans. 0000049042 00000 n You keep what you dont spend on medical expenses, even if you retire or leave state employment. 0000045752 00000 n Once logged in, navigate to the https://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/no-fault-changes.html 0000018397 00000 n When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. See your 2023 Benefits-at-a-Glance (PDF) for more plan details. 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 Utilize the Insurance Planspage to review plan summaries or contact the HMO that interests you to request their benefit booklet. Take a look at what Blue Cross plans offer, then choose the one that's right for you. 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. 0 606 0 obj <>stream When we look again at the total cost of having and using the plans, the HSA Plan is the lower cost option for John. 0000008674 00000 n Click My Plan and Spending. 140 0 obj <> endobj "Qualified Health Coverage" means your health coverage: Does not exclude or limit coverage for motor vehicle accidents; and Has an annual deductible of $6,000.00 or less per covered individual. 0000010919 00000 n Government Human Resources Benefits Health Benefit Plans. 141 0 obj 0000006389 00000 n Qualified health coverage is health or accident insurance that doesn't exclude or limit coverage for injuries from auto accidents. 0000059656 00000 n 159 0 obj <>/Filter/FlateDecode/ID[<38505CF35D4D814CB849C61D42F0BD2C>]/Index[140 54]/Info 139 0 R/Length 99/Prev 142241/Root 141 0 R/Size 194/Type/XRef/W[1 3 1]>>stream 120 0 obj 0000013137 00000 n 0000048613 00000 n We provide health insurance in Michigan. Those costs include increased copay and deductible amounts. It has more than 20,000 physicians, including specialists, and more than 140 all acute care hospitals in Michigan. 0000009570 00000 n 0000048207 00000 n Health Insurance Marketplace Check out information about the Marketplace, especially if you are not eligible for coverage through LCC. Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health 0000008446 00000 n To file a Blue Cross Blue Shield Global Core eClaim online, log in with your username and password or register for access. When an out-of-area Blue plan member seeks medical care from your office, use our tools to simplify claims submission to Blue Shield of California. 0000043394 00000 n Qualified Transportation Fringe Benefits (QTFB). 0 | _1S}9M{T=o9B^>.!a8Znpk9(6_ `+DO>|5%Nqdws=0y';L a66[OIe,%EqtRS&54Qvw"E$iu3:G+x+II^ UTT"9W!4XuYS6Ly}l&!2 Visit myfordbenefits.com and make your plan selection for 2023. 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. So when we consider the total cost to have and use the plans, the HSA Plus Plan is the less costly option. <>stream 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. 0000059211 00000 n 0000014332 00000 n 0000048472 00000 n The HSA balance belongs to the employee and can be carried over from year to year. Current SHP PPO enrollees will be automatically transitioned with no gap or changes in coverage. For Medicare Members: No-fault auto law changes bcbsm.com Health (Just Now) WebThere are several ways you can request a QHC letter. The maximum deductible for two or more covered persons in your family was limited to 1 months of your basic salary. 0000027473 00000 n Mary would pay nothing from her paycheck to have the HSA Plan. 0000012102 00000 n Create an account now. You can now file disputes, attach supporting documents, and retrieve letters for submitted disputes online! 0000014991 00000 n 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. Go paperless by submitting claims and managing payments online for free. The network covers all 83 Michigan counties and is the largest PPO network in 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). <> For the HSA Plus Plan, Ford contributes $1,000 towards Mary's health savings account, which further reduces her cost to use this plan. 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. This plan covered inpatient hospital expenses, as well as certain other services received at the hospital on an outpatient basis (including emergency room care). See below. 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). 0000005858 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. 0000020507 00000 n Pontiac, MI 48341. This is the amount taken from your pay each month. 0000008243 00000 n Per state and federal law, providers and facilities must attest to accuracy of directory information to stay visible in find a Doctor. For all other claims, choose your health plan on this page to find the form and instructions for sending it in. We're redirecting you to Blue Shield of California's Find a doctor search. Blue Cross Blue Shield of Michigan: Understanding member ID cards 0000010545 00000 n We're sorry, but the attestation service is temporarily unavailable. 0000024600 00000 n 800-229-2210 Mail Code 1112. Employees can also make pre-tax HSA contributions by payroll deductions. 0000026848 00000 n 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. Contact your auto insurance carrier for specific questions regarding PIP coverage. 0000049165 00000 n PIP is the part of an auto insurance plan that covers the health care costs from a car . Demographics |Electronic Data Interchange (EDI) | Recoveries, Need help with Provider Connection: Blue Shield Provider Connection Guide Provider Connection training. 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. Simply Blue. The document must: Links to all provider websites can be found on our Benefit Carrier Contact Information page. (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 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. 0000014702 00000 n 0000020798 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. %%EOF 0000006930 00000 n 0000018138 00000 n State and Federal Privacy laws prohibit unauthorized access to Member's private information. 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. 'TMjZ}dM`V;hO0 45o` T@> $0,Tkpp9~#@="-toen7=u-J 3P6sO1v 0IA||$IRs3R6o'j*vU#;B!FL5O,hBtA7|$xVv)*09KTOM8Gh6CAIT,[*6a8 wz 0000051836 00000 n Please enable JavaScript in your browser for a better user experience. California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. Submit and confirm authorizations and approval of medical and pharmacy services prior to services being rendered. lo%x9d,oqM lzgw'TK6oB~+d; {qi.B/ R`]Hcq6~s_]=y&|9]Fl2b\o9Vp"(5Z9lb.dx;@? *Mii lkSW+0XI~'kT`C>?wlvR \8/$z This copay is waived if Mary or her family member is admitted as a result of the ER visit. trailer Your explanation of benefits (EOB) statement has a new look. <>/Filter/FlateDecode/ID[<640396EC155E3E4385DE44C7EB07AE63>]/Index[119 54]/Info 118 0 R/Length 102/Prev 42314/Root 120 0 R/Size 173/Type/XRef/W[1 2 1]>>stream xref TTY users should call 711. 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. The HSA Plan is available to you at no cost. Here's how these plans work. Ford offers an accelerated contribution option. &yw}.$7eIw <. 0000059965 00000 n 1tv 0000030483 00000 n 0000017479 00000 n For more information about the State of Michigan's eligibility requirements for employee health insurance coverage, . 0000019721 00000 n Try again later. We'll accept a qualification form from an office visit that occurred up to 180 days before the start of your plan year. Blue Shield/Blue Shield Promise network referrals. #G:&#WeKo]b287X]4 fd!n>X3jG[)GW%0.{1,JqA]Vf,fyf#Ji+OvDUpe!K|\"e2{g3ePW?/p Member logins offer many on-line tools, such as access to claims information, viewing Explanation of Benefits, printing replacement ID cards, etc. 0000059887 00000 n Available for commercial, Shared Advantage, and BlueCard. 600 Lafayette East. 0000029757 00000 n hbbd```b``z"@$D2e5A$)e,H^0 This amount does not count toward the plan's out-of-pocket maximum. 0000034422 00000 n 0000020133 00000 n 0000029999 00000 n New SHP PPO membership ID cards will be mailed in September 2019. You can log in to your online member account to see if you have a QHC letter to download. When asked to log in, choose Continue as a guest. Log in to continue with member verification. 0000026163 00000 n The Plan also covers most of your community-based care (office visits), as well as necessary medical equipment and supplies (crutches, hearing aids, etc.). 0000004500 00000 n 0000022731 00000 n 0000013426 00000 n In 2021, you'll have a choice between two HSA eligible medical plans, HSA Plan and HSA Plus Plan. h1aMXk* Q)DDJjH$*F 0000010017 00000 n XYQ This product provides comprehensive PPO coverage with costsharing features. 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. 0000017849 00000 n For example: a single person chooses an in-network hospital for surgery. Before you select a medical plan, consider your total costs, including the costs to have and use the plan. If the provider you select doesn't participate at all with BCBSM (BCBSM has several different provider arrangements), you may also be required to pay additional charges. You can log in to your online member account to see if you have a QHC letter to download. 0000025213 00000 n Learnyour requirements, deadline dates and more about your coverage. 0000023650 00000 n 0000042215 00000 n 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. bcbsm.com. 0000033229 00000 n You can also opt-out if you qualify for that provision. 0000027625 00000 n 0000017188 00000 n 0000016573 00000 n To help you compare and select your 2021 medical plan, Ford has provided Benefits Mentor powered by IBM Watson Health. 0000025504 00000 n 0000004052 00000 n 0000005259 00000 n 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.