bcbsm qualified health coverage letter

0000021168 00000 n 0000026848 00000 n Thank you for viewing. Members should direct specific questions about PIP coverage to their auto insurer. 0000035230 00000 n 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 $21M to Individual Plan Members, Increasing Access to Behavioral Health Care in the Face of COVID-19, Concussions: The Warning Signs You Need to Know, Are You the Default Parent? 0000026320 00000 n We can help. endstream endobj startxref }v".VrTAmk$NJ+ y{i-Y#gds7D 0000017188 00000 n 0000006930 00000 n 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 Visit myfordbenefits.com and make your plan selection for 2023. Ford offers an accelerated contribution option. Depending the level of PIP you choose, your auto insurer may request a letter stating whether you have qualified health coverage, or QHC. Under the new legislation, residents may select different levels of PIP coverage. 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. If you choose to do so, you will be responsible for both deductibles. Individuals attempting unauthorized access will be prosecuted. For example: a single person chooses an in-network hospital for surgery. 0000005858 00000 n If you are new to an HMO, that HMO may ask you to select your primary care physician. 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). 0000023020 00000 n 0000048173 00000 n This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. 0000027161 00000 n TTY users should call 711. Utilize the Insurance Planspage to review plan summaries or contact the HMO that interests you to request their benefit booklet. Simply Blue. 0000020507 00000 n 141 0 obj California Physicians Service DBA Blue Shield of California 1999-2023. When you combine Mary's cost to have and use the HSA Plus Plan, her total cost is $5,306. endobj You can call the number on the back of your member ID card. 0000036634 00000 n The web Browser you are currently using is unsupported, and some features of this site may not work as intended. The HSA balance belongs to the employee and can be carried over from year to year. These plans also allow you to set aside tax-free funds that you can use for qualified medical expenses. Log in to continue with member verification. 0000014332 00000 n Member logins offer many on-line tools, such as access to claims information, viewing Explanation of Benefits, printing replacement ID cards, etc. Thank you for viewing. So when we consider the total cost to have and use the plans, the HSA Plus Plan is the less costly option. 0000005441 00000 n The deductible is the amount you pay before your plan contributes to your costs. They are responsible for the out-of-network deductible. 0000014041 00000 n To request your QHC confirmation letter: Log in to your member account. It has more than 20,000 physicians, including specialists, and more than 140 all acute care hospitals in Michigan. Access tools to prescreen, submit and check the status of submitted claims. Field Service. 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. This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. Create an account now. Contact your auto insurance agent with questions and to learn more about your options. 1tv 0000048349 00000 n If you absolutely need to call, please try again at a later date. 120 0 obj We're sorry, but the attestation service is temporarily unavailable. 0000029225 00000 n 0000023650 00000 n 0000031798 00000 n After that deductible is met, out-of-network charges are paid according to the plan design. You can log in to your online member account to see if you have a QHC letter to download. When you see a HMO in-network provider for covered services, your out-of-pocket costs are limited to deductibles (starting October 12, 2014), and copays. After your deductible is met, co-insurance applies to medical and prescription costs until your out-of-pocket maximum is met. New SHP PPO membership ID cards will be mailed in September 2019. Your doctor will submit the form by following the instructions on the back. N'JV|DI]Ea:%*&[|{;z^HzwD/L_d?D/q|',W2tKpcukU;Bxc%w37XeNh{%_hl@zPMy * uAd;{i6pmn'D=6e Cvy"ngpdh6 s/8bG. 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. K4[WYV5pL@=>QBuD State Health Plan PPO - Administered by Blue Cross Blue Shield of Michigan (BCBSM). 0000018138 00000 n Qualified health coverage is health or accident insurance that doesn't exclude or limit coverage for injuries from auto accidents. 0000048755 00000 n Visit Federal No Surprises Act (michigan.gov)for more information. They won't charge you the difference between their normal charge and the amount paid by the State Health Plan PPO. James has arthritis, so he needs to take a higher cost maintenance drug. Learnyour requirements, deadline dates and more about your coverage. Let's start with Mary who selected a plan to cover her family. <<674A7177E0417F4590EC384E93D00AED>]>> 0000030483 00000 n 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. 0000004500 00000 n With the total of all her family services and prescriptions, the HSA Plan costs $3,030 to use. 0000027006 00000 n 0000031112 00000 n To file a Blue Cross Blue Shield Global Core eClaim online, log in with your username and password or register for access. This tool provides side-by-side medical plan comparisons and personalized cost modeling. We're making your EOB easier to understand. 0000006145 00000 n Blue Cross Blue Shield of Michigan. 248-524-0454 Other costs to use the HSA Plan will vary depending on whether you select plan coverage for you or for your family. 0000007848 00000 n "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. Plan: Blue Care Network (BCN) Premium Cost: Summer 5/16/20 - 8/15/20 $474.00 (approx. Select Claims on the menu bar. 0000059965 00000 n 0000048683 00000 n These scenarios are simple, and there are many other ways you can consider managing your out-of-pocket costs with your health savings account. 0000031415 00000 n Physician Qualification Form (PDF) Healthy Blue Achieve Form &yw}.$7eIw When asked to log in, choose Continue as a guest. Now let's look at some helpful scenarios that show how these plans work, considering the costs to have and use each plan. When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. We provide health insurance in 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.). 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. 0000010017 00000 n 0000028562 00000 n i' *eW This provides cost and other information related to your plan options. You don't need to wait until your new plan year starts to see your doctor. 0000017479 00000 n 0000027316 00000 n 0000022731 00000 n 0000026660 00000 n XYQ This product provides comprehensive PPO coverage with costsharing features. 0000010306 00000 n 140 0 obj <> endobj endstream 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 BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. It has a deductible of $6,000 or less per person. To find the most up-to-date information about current medical and pharmacy claims, you can use the Blue Cross app or log into your BCBSM member account at bcbsm.com. If your auto insurance is requesting a QHC letter to issue or renew a policy, you may request a QHC letter by contacting yourhealth carrier. Telemedicine Benefit Summary:Telemedicine visits allow you to meet with a US board-certified doctor online using a video-chat tool. 0000011210 00000 n 0000033132 00000 n Please enable JavaScript in your browser for a better user experience. IS IBCQ-]97T5dUa{ugdcg`\o'.Nu }n|7G|ZXXMf9I\RTt K{d\H3$]S^-}h C6PDI^7|[N$G3y\80-~/T2;D->>DRUw_ F=(8#l9o&.fy66tK~yUR~YZOa.y=jYh8MfH3eXg]s#2H`pw$]Nx8p&`1l)v1]\Ib`wO6+1OLn@{hE +vA3LSY+o(*_6]o. 0000028854 00000 n Submit and confirm authorizations and approval of medical and pharmacy services prior to services being rendered. 93gpm},|P gaToY%+IzO96`%n'`Pll@BJa %PDF-1.7 % 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. 0000034422 00000 n The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. This is the amount taken from your pay each month. 0000059211 00000 n 0000023276 00000 n 866-503-3158 0000037572 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. 0000039800 00000 n Please see below for further information. 193 0 obj <>stream Oakland County's Qualified Health Coverage Letter for Retiree Notice of Qualified Health Coverage for Purposes of Michigan No-Fault Auto Law Medical Health Plans ASR Plan Documents ASR PPO 1 Plan Document ASR PPO 3 Plan Document Summary of Benefits and Coverage 2023 PPO 1 Summary of Benefits and Coverage 2023 PPO 3 Summary of Benefits and Coverage <. 0000015249 00000 n For more info, visitwww.mi.gov/AutoInsurance, emailAutoInsurance@mi.gov, or call 833-ASK-DIFS (275-3437). 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. 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. For Medicare Members: No-fault auto law changes Health (Just Now) WebThere are several ways you can request a QHC letter. You have certain tasks to complete within specific . If you don't have a Provider Connection account, you will need to register before logging in. Co-insurance is a percentage of the cost you share with the plan. In our next scenario, James covers his wife on his medical plan. 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. You can also review your current plan to help make the best choice for 2021. What's qualified health coverage under the new law? 0000007628 00000 n 0000047030 00000 n 800-229-2210 0000027473 00000 n 0000048834 00000 n Qualified Transportation Fringe Benefits (QTFB). We appreciate your understanding. .r~'J ms-oA&@i 9k2 J4T{Yt;cu6J_Fs"6r|(Z? Members enrolled in the HSA plan will be responsible for paying an ER copayment after the deductible has been met. 0000036168 00000 n Find information about Promise Medi-Cal and Cal MediConnect, our policies, procedures and programs. www.bcbsm.com/som, State High Deductible HealthPlan (HDHP) withHealth Savings Account (HSA)- HDHP administered by Blue Cross Blue Shield of Michigan (BCBSM),HSA administered by HealthEquity. 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. 0000014702 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 copay is waived if Mary or her family member is admitted as a result of the ER visit. Michigans new auto no-fault insurance law went into effect July 1, 2020. 0000003914 00000 n 0000009570 00000 n Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health As you can see, there are great benefits to having an HSA. You can also opt-out if you qualify for that provision. 119 0 obj *Blue Shield of California member plans only, Pre-service review for out-of-area members. Once logged in, navigate to the https://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/no-fault-changes.html 0000060102 00000 n 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 hb``a`` -mY8PE!u[dCC#W6,j.Fvtl,s fb`p;CT3j Learn about our tools and how to use them in our upcoming webinars. You can keep your unlimited PIP coverage. Healthcare includes your Medical (ASR, BCBS, or HAP), Prescription (Navitus or HAP), Dental (Delta Dental), and Vision (NVA). Your email address will not be published. Respond promptly to the carrier to complete the final phase of the enrollment process. Behavior Health/Substance Use Disorder Administrator. hbbd```b``z"@$D2e5A$)e,H^0 0000027625 00000 n Please keep in mind that PIP coverage pays for some items that health insurance doesnt, such as attendant care, lost wages and vehicle or housing modifications. Simply . 1-313-225-9000. 0000014991 00000 n Mary would pay nothing from her paycheck to have the HSA Plan. Your co-insurance amount for in-network services is 20%. Two letters confirming you have MESSA coverage that are often requested by your auto insurance carrier can be found in your MyMESSA member account. Links to all provider websites can be found on our Benefit Carrier Contact Information page. Those costs include increased copay and deductible amounts. Qualified Health Coverage Documents DIFS Bulletin 2020-01-INS advises health plans should develop a document that indicates whether a person's coverage is "qualified health coverage" or QHC for purposes of the new no-fault law. 0000000016 00000 n 0000019892 00000 n 0000032373 00000 n startxref Please provide the following information about the policy holder of the other health coverage. 0000041020 00000 n 0000059656 00000 n Earnings on an HSA fund balance are tax-free, and you can withdraw your money tax-free anytime, as long as you use it for qualified medical expenses for yourself or your tax dependents. To request a proof of qualified health coverage letter, contact Blue Cross' Customer Service department at 1-800-422-9146from 8:30 a.m. to 5 p.m. Eastern time, Monday through Friday. If your auto insurance is requesting a QHC letter to issue or renew a policy, you may request a QHC letter by contacting your health carrier. 0000025874 00000 n The network covers all 83 Michigan counties and is the largest PPO network in Michigan. If the provider you select doesn't participate at all with BCBSM (BCBSM has several different provider arrangements), you may also be required to pay additional charges. 0rtq]%g=z.#i0\*m(D2q;t2}$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=. An HDHP offers a lower biweekly premium in exchange for higher deductibles and out-of-pocket limits. 0000019432 00000 n Health Insurance Marketplace Check out information about the Marketplace, especially if you are not eligible for coverage through LCC. What does PIP cover? [Instructor] Hello, and welcome to Blue Cross Blue Shield of Michigan. 0000048613 00000 n You can use the money if you leave the company, change your plan, or retire. 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. 0000027783 00000 n Later in the year, that same person needs an MRI and chooses an out-of-network provider. To help your savings grow even more, when your HSA balance reaches $1,000, you can choose a variety of investments. View the Telemedicine Benefit Summary to see your State-sponsored health insurance carrier's telemedicine coverage. John's annual paycheck deduction for the HSA Plan is zero. Your explanation of benefits (EOB) statement has a new look. 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. 0000023941 00000 n Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. 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. 13 151 0000024311 00000 n 0000026478 00000 n An HMO is a managed care plan that provides medical care through its network of physicians, pharmacies, contracted hospitals, and medical care suppliers. | _1S}9M{T=o9B^>.!a8Znpk9(6_ 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 Try again later. 0000022070 00000 n endstream endobj 14 0 obj <. With the HSA Plan, you pay 100% of medical and prescription costs until your deductible is met. Reviewplan materialscarefully to understand the advantages and risks associated with the plan. View detailed plan information in this document. 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. Detroit, MI 48226-9942. For the HSA Plus Plan, Ford contributes $1,000 towards Mary's health savings account, which further reduces her cost to use this plan. `+DO>|5%Nqdws=0y';L a66[OIe,%EqtRS&54Qvw"E$iu3:G+x+II^ UTT"9W!4XuYS6Ly}l&!2 0000030725 00000 n *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). View the eGuide to see the Ford resources available all year long. (MSPTA-represented only) And he pay $2,280 annually to have the HSA Plus Plan. PIP pays for services that health insurance may or may not cover. Before you select a medical plan, consider your total costs, including the costs to have and use the plan. b|=b}#Aif3TRD0;@NHkQ#`VEQxD 0000049102 00000 n James wouldn't have to pay anything from his paycheck to have the HSA Plan. 0000048540 00000 n Contact your auto insurance carrier for specific questions regarding PIP coverage. If you have any questions, call the phone number on the back of your Blue Cross ID card and we'll help. $158 per month) Eligibility: All MSU students, Law students, Visiting scholars, and more, including spouse and children of a student enrolled in the plan. GradCare Member Reimbursement Form U-M Premier Care Member Reimbursement Form 0000030241 00000 n 0000049165 00000 n %%EOF To help you compare and select your 2021 plan based on your personal needs, Ford has provided Benefits Mentor powered by IBM Watson Health. 0 The out-of-pocket maximum does not include monthly paycheck contributions, copayments, or any expenses not covered by your plan. You can log in to your online member account to see if you have a QHC letter to download. h1aMXk* Q)DDJjH$*F This tool provides side-by-side medical plan comparisons and personalized cost modeling.

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