bcbsm qualified health coverage letter

Let's say Mary and her family have a normal year with normal doctor visits. Those costs include increased copay and deductible amounts. Government Human Resources Benefits Health Benefit Plans. An HDHP offers a lower biweekly premium in exchange for higher deductibles and out-of-pocket limits. 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 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. 0000028854 00000 n Before you select a medical plan, consider your total costs, including the costs to have and use the plan. 120 0 obj 0000049102 00000 n 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). 0000048472 00000 n hb``a`` -mY8PE!u[dCC#W6,j.Fvtl,s fb`p;CT3j Other costs to use the HSA Plan will vary depending on whether you select plan coverage for you or for your family. 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). Ford offers an accelerated contribution option. 0000019432 00000 n 0000025504 00000 n If you absolutely need to call, please try again at a later date. Detroit, MI 48226-9942. New SHP PPO membership ID cards will be mailed in September 2019. You can call the number on the back of your member ID card. James has arthritis, so he needs to take a higher cost maintenance drug. 0000024311 00000 n 866-503-3158 0000028187 00000 n K4[WYV5pL@=>QBuD 0000020507 00000 n PPO. 0000048173 00000 n This is the amount taken from your pay each month. 0000032096 00000 n 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. The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. This plan didn't cover prescription charges, office visit charges, medical equipment, psychiatric services, or other major medical services. 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). 0 13 0 obj <> endobj 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. 0000048349 00000 n 163 0 obj <>stream You can keep your unlimited PIP coverage. We'll accept a qualification form from an office visit that occurred up to 180 days before the start of your plan year. 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). (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 John's annual paycheck deduction for the HSA Plan is zero. 0000029757 00000 n 0000030483 00000 n 0000010919 00000 n %PDF-1.7 % 0000009570 00000 n 0000003914 00000 n To request your QHC confirmation letter: Log in to your member account. 0000027006 00000 n 0000029515 00000 n Mail Code 1112. This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. Try again later. 0000004937 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 your health carrier. Reviewplan materialscarefully to understand the advantages and risks associated with the plan. Once logged in, navigate to the https://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/no-fault-changes.html You can also review your current plan to help make the best choice for 2021. 0000029999 00000 n 0000059211 00000 n 0 You can now file disputes, attach supporting documents, and retrieve letters for submitted disputes online! 0000048540 00000 n What does PIP cover? 0000026163 00000 n You may look up HMOs in your residential area using the zip code tool. Qualified health coverage is health or accident insurance that doesn't exclude or limit coverage for injuries from auto accidents. An HMO is a managed care plan that provides medical care through its network of physicians, pharmacies, contracted hospitals, and medical care suppliers. 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 The Plan also covers most of your community-based care (office visits), as well as necessary medical equipment and supplies (crutches, hearing aids, etc.). 606 0 obj <>stream Demographics |Electronic Data Interchange (EDI) | Recoveries, Need help with Provider Connection: Blue Shield Provider Connection Guide Provider Connection training. Your explanation of benefits (EOB) statement has a new look. Plan: Blue Care Network (BCN) Premium Cost: Summer 5/16/20 - 8/15/20 $474.00 (approx. 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. They won't charge you the difference between their normal charge and the amount paid by the State Health Plan PPO. 0000048277 00000 n 248-524-0454 Now let's look at some helpful scenarios that show how these plans work, considering the costs to have and use each plan. Depending the level of PIP you choose, your auto insurer may request a letter stating whether you have qualified health coverage, or QHC. b|=b}#Aif3TRD0;@NHkQ#`VEQxD You don't need to wait until your new plan year starts to see your doctor. For the HSA Plus Plan, her yearly contributions, which is her cost to have the plan would be $3,300. For more info, visitwww.mi.gov/AutoInsurance, emailAutoInsurance@mi.gov, or call 833-ASK-DIFS (275-3437). 0rtq]%g=z.#i0\*m(D2q;t2}$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=. 0000048834 00000 n View the Telemedicine Benefit Summary to see your State-sponsored health insurance carrier's telemedicine coverage. 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. 0000012476 00000 n 0000031415 00000 n Blue Cross Blue Shield of Michigan. The State Health Plan PPO provides reimbursement for medical care expenses when you need treatment for an illness, injury, or disease. Thank you for viewing. 600 Lafayette East. When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. And he pay $2,280 annually to have the HSA Plus Plan. Health Trust 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. 0000030725 00000 n 258 0 obj <> endobj 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"). 0000027316 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 update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. 0000021168 00000 n You can log in to your online member account to see if you have a QHC letter to download. 0000022731 00000 n 0000021696 00000 n To help you compare and select your 2021 medical plan, Ford has provided Benefits Mentor powered by IBM Watson Health. 0000005858 00000 n 0000022070 00000 n 0000003382 00000 n Your co-insurance amount for in-network services is 20%. Or, call the number on the back of your member ID card. 0000060222 00000 n #G:&#WeKo]b287X]4 fd!n>X3jG[)GW%0.{1,JqA]Vf,fyf#Ji+OvDUpe!K|\"e2{g3ePW?/p You have certain tasks to complete within specific . 0000027625 00000 n Automobile No-Fault Insurance Changes: Prior to July 2, 2020, Michigans Automobile No-Fault Insurance Law required individuals to purchase unlimited Personal Injury Protection (PIP) through their auto insurer. Provided in a vehicle qualified as an ambulance and part of a licensed ambulance operation GradCare Member Reimbursement Form U-M Premier Care Member Reimbursement Form 0000006389 00000 n 0000004500 00000 n 0000048976 00000 n If you are new to an HMO, that HMO may ask you to select your primary care physician. State and Federal Privacy laws prohibit unauthorized access to Member's private information. 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). 0000020133 00000 n This means you have the option to increase your payroll contributions so you can reach the maximum contribution amount earlier in the year. Even though this law has to do with your auto insurance, a lot of people have questions about what it means for your. Please provide the following information about the policy holder of the other health coverage. MSU Student Health Insurance Plan. In the HSA Plus Plan, you're also responsible for all medical and prescription costs until your deductible is met. Michigans new auto no-fault insurance law went into effect July 1, 2020. 0000026848 00000 n 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 After your deductible is met, co-insurance applies to medical and prescription costs until your out-of-pocket maximum is met. Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader, Important Information About MedicarePlans. 0000034422 00000 n HSA Plan and HSA Plus Plan. California Physicians Service DBA Blue Shield of California 1999-2023. Enroll when you're ready. 0000012767 00000 n 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 . Telemedicine Benefit Summary:Telemedicine visits allow you to meet with a US board-certified doctor online using a video-chat tool. 0000005259 00000 n endobj 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 Field Service. With the total of all her family services and prescriptions, the HSA Plan costs $3,030 to use. After the deductible and coinsurance are applied for the HSA Plus Plan, James will be responsible for $3,480. 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 . 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. 0000015249 00000 n Questions About Your Benefits? 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. Your email address will not be published. When we look again at the total cost of having and using the plans, the HSA Plan is the lower cost option for John. 0000023650 00000 n Here's how these plans work. 0000032373 00000 n %PDF-1.7 % 140 0 obj <> endobj Employees can now get a Health Care Plan Verification letter through Wolverine Access by selecting Employee Self-Service > Benefits > Health Care Plan Verification. 0000005441 00000 n The maximum deductible for two or more covered persons in your family was limited to 1 months of your basic salary. %PDF-1.6 % 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. We're redirecting you to Blue Shield of California's Find a doctor search. 0000021457 00000 n But, if you receive services from a provider not in the PPO network, you may be responsible for paying additional out-of-pocket costs. 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. 0000024600 00000 n 0000008905 00000 n Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. <>stream 0000006930 00000 n 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 $2,480. To find the most up-to-date information about current medical and pharmacy claims, you can use the Blue Cross app or log into your BCBSM member account at bcbsm.com. If you have additional BCBSM contracts, pleas e include this as other coverage. 0000049042 00000 n 0000015914 00000 n Please enable JavaScript in your browser for a better user experience. Federal No Surprises Act: The federal government issued the "transparency in coverage" final rule under the Federal No Surprises Act. Blue Cross Blue Shield of Michigan, in partnership with Lucet h1aMXk* Q)DDJjH$*F 0000029225 00000 n This plan covered inpatient hospital expenses, as well as certain other services received at the hospital on an outpatient basis (including emergency room care). 0000048916 00000 n 0000017479 00000 n We appreciate your understanding. This tool provides side-by-side medical plan comparisons and personalized cost modeling. Identified standard preventive services are covered at 100%, but most other services have a 20% in-network coinsurance after meeting the deductible. 0000004148 00000 n XYQ This product provides comprehensive PPO coverage with costsharing features. We're making your EOB easier to understand. 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. <> An HSA is a smart way to save for your future qualified health expenses, including those that may come up in retirement. $158 per month) Eligibility: All MSU students, Law students, Visiting scholars, and more, including spouse and children of a student enrolled in the plan. Learn about our tools and how to use them in our upcoming webinars. Members enrolled in the HSA plan will be responsible for paying an ER copayment after the deductible has been met. Learnyour requirements, deadline dates and more about your coverage. 0000027945 00000 n Learn more about your Blue Cross Blue Shield of Michigan plan options. 0000007100 00000 n {07 N_Bdk em4MVRpH ~*.V%s^5h}R,uJXP;6s@bH{{J 4aWS8r *W~oKMwSV-Kl^voIb #TY^hAP38HUR{mv8azF`lAQm8yiKm77!}1nW The out-of-pocket maximum does not include monthly paycheck contributions, copayments, or any expenses not covered by your plan. Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health }v".VrTAmk$NJ+ y{i-Y#gds7D 93gpm},|P gaToY%+IzO96`%n'`Pll@BJa xref 1tv 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. Representatives are available 8:00 a.m. to 5:00 p.m., Monday through Friday. 0000033132 00000 n 0000012102 00000 n 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. For the HSA Plan, your deductible and out-of-pocket maximum amounts for in-network services are the same. After that deductible is met, out-of-network charges are paid according to the plan design. Log in to get your questions answered by a live representative, Monday through Friday, 6 a.m. to 6:30 p.m. For auto insurance policies issued or renewed after July 1, 2020, Michigan's Automobile No-Fault Insurance Law will change. 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. Contact your auto insurance carrier for specific questions regarding PIP coverage. 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. 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. 0000011869 00000 n No-fault auto insurance changes in Michigan bcbsm.com Health (6 days ago) WebThere are several ways you can request a QHC letter. 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. When asked to log in, choose Continue as a guest. endstream endobj startxref 0000018397 00000 n Benefits under this plan were payable only after you had paid expenses equal to one month's basic salary (your deductible). California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. 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. 0000049165 00000 n 'TMjZ}dM`V;hO0 45o` T@> $0,Tkpp9~#@="-toen7=u-J 3P6sO1v 0IA||$IRs3R6o'j*vU#;B!FL5O,hBtA7|$xVv)*09KTOM8Gh6CAIT,[*6a8 wz 0000018138 00000 n 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. This copay is waived if Mary or her family member is admitted as a result of the ER visit. State Health Plan PPO - Administered by Blue Cross Blue Shield of Michigan (BCBSM). Click My Plan and Spending. Don't have a member account? (tJ)Dpdd5* 7YG1}[X3C=Yvou*tdU`{NRGqZy3Cv{c.W+5gE|7?)z %PDF-1.7 % Follow the instructions on the page to have your letter created. 0000020798 00000 n Employees can also make pre-tax HSA contributions by payroll deductions. Respond promptly to the carrier to complete the final phase of the enrollment process. 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. And for the HSA Plus Plan, it's $1,020. Both plans include a health savings account HSA. 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. Callers to our phone lines are currently experiencing long wait times. Please see below for further information. Please refer to www.bcbsm.com/som for the list of providers. View detailed plan information in this document. PIP coverage can include items like attendant care, housing modifications and lost wages. *Blue Shield of California member plans only, Pre-service review for out-of-area members. 0000031112 00000 n You are encouraged to visit your benefit providers' website and create free member logins. To obtain a coordination of benefits letter, call the number on the back of your Enrollee ID card. See your 2023 Benefits-at-a-Glance (PDF) for more plan details. Visit myfordbenefits.com and make your plan selection for 2023. 0000027783 00000 n SM. They areresponsible for the deductible, then the hospital is reimbursed according to the plan design. 0000023276 00000 n <<674A7177E0417F4590EC384E93D00AED>]>> Give us a call to discuss your plan options. 0000013426 00000 n It has more than 20,000 physicians, including specialists, and more than 140 all acute care hospitals in Michigan. 0000059887 00000 n 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. 0000023941 00000 n Simply . 193 0 obj <>stream Providers and facilities that fail to comply will be suppressed from our directories. Access commonly requested forms for patient care activities, credentialing, and more. 0000025874 00000 n 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 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.

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