0000059887 00000 n &yw}.$7eIw When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. Claims | Benefits | Member eligibility | How to use Provider Connection | Contracts | Credentialing | Pontiac, MI 48341. 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. 0000008905 00000 n What's qualified health coverage under the new law? 0000022731 00000 n 0000035745 00000 n There are several ways you can request a QHC letter. 0000059965 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 . And he pay $2,280 annually to have the HSA Plus Plan. 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. 0000021457 00000 n View the eGuide to see the Ford resources available all year long. Current SHP PPO enrollees will be automatically transitioned with no gap or changes in coverage. 0000058981 00000 n 0000024311 00000 n *Blue Shield of California member plans only. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Now let's look at some helpful scenarios that show how these plans work, considering the costs to have and use each plan. 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 . 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. 0000004500 00000 n 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. The account and money are yours. 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. 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. *Note: MSPTA-represented (T01) employees, DROP employees, and Other Eligible Adult Individuals (OEAIs) and their dependents are not eligible for this benefit. Use the Find-a-Doctor tool to verify provider participation in one of our plan networks. The HSA Plan is available to you at no cost. An HMO is a managed care plan that provides medical care through its network of physicians, pharmacies, contracted hospitals, and medical care suppliers. You can log in to your online member account to see if you have a QHC letter to download. Physician Qualification Form (PDF) Healthy Blue Achieve Form 0000034485 00000 n The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. xref 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. Enroll when you're ready. 0000007100 00000 n Go paperless by submitting claims and managing payments online for free. 0000032096 00000 n For the HSA Plan, your deductible and out-of-pocket maximum amounts for in-network services are the same. 0000036168 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. Your Benefit Guide State Health Plan PPO 3 Visit BCBSM Customer Service Center 232 S. Capitol Ave. Lansing, MI 48933 . 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. 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). 0000019721 00000 n 0000006930 00000 n 0000048349 00000 n 0000048613 00000 n Learn about our tools and how to use them in our upcoming webinars. This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. SECTION 2 OTHER HEALTH COVERAGE INFORMATION . 0000030241 00000 n 0000017188 00000 n Submit and confirm authorizations and approval of medical and pharmacy services prior to services being rendered. 0000048173 00000 n .r~'J ms-oA&@i 9k2 J4T{Yt;cu6J_Fs"6r|(Z? You're now aware you have a choice between two HSA eligible medical plans in 2021. 373 0 obj <>stream 0000049042 00000 n 0000007628 00000 n 0000060222 00000 n 0000008446 00000 n GradCare Member Reimbursement Form U-M Premier Care Member Reimbursement Form endstream endobj startxref With the total of all her family services and prescriptions, the HSA Plan costs $3,030 to use. For Medicare Members: No-fault auto law changes bcbsm.com Health (Just Now) WebThere are several ways you can request a QHC letter. Please provide the following information about the policy holder of the other health coverage. 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. You must be in pay status to receive this payment. 0000024839 00000 n 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. See below. 0000018771 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. Learn more about your Blue Cross Blue Shield of Michigan plan options. 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. Select Claims on the menu bar. View detailed plan information in this document. 0000030725 00000 n 800-229-2210 lo%x9d,oqM lzgw'TK6oB~+d; {qi.B/ R`]Hcq6~s_]=y&|9]Fl2b\o9Vp"(5Z9lb.dx;@? *Mii lkSW+0XI~'kT`C>?wlvR You can choose your own primary care physician who will provide direct care or make referrals from within the network. If you choose to do so, you will be responsible for both deductibles. To help you compare and select your 2021 plan based on your personal needs, Ford has provided Benefits Mentor powered by IBM Watson Health. Behavior Health/Substance Use Disorder Administrator. <> 0000048976 00000 n endstream Benefits under this plan were payable only after you had paid expenses equal to one month's basic salary (your deductible). 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. %%EOF *Blue Shield of California member plans only, Pre-service review for out-of-area members. For auto insurance policies issued or renewed after July 1, 2020, Michigan's Automobile No-Fault Insurance Law will change. View the Telemedicine Benefit Summary to see your State-sponsored health insurance carrier's telemedicine coverage. 0000009279 00000 n The out-of-pocket maximum does not include monthly paycheck contributions, copayments, or any expenses not covered by your plan. 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. Thank you for viewing. 0000027945 00000 n 172 0 obj 0000004937 00000 n Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. 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. 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. endstream endobj 14 0 obj <. All rights reserved. 141 0 obj This plan covered inpatient hospital expenses, as well as certain other services received at the hospital on an outpatient basis (including emergency room care). Thank you for viewing. 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. 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 $21M to Individual Plan Members, Increasing Access to Behavioral Health Care in the Face of COVID-19, Concussions: The Warning Signs You Need to Know, Are You the Default Parent? Log in to continue with member verification. We appreciate your understanding. 0000048540 00000 n 0000003382 00000 n 0rtq]%g=z.#i0\*m(D2q;t2}$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=. 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). Learnyour requirements, deadline dates and more about your coverage. 0000011580 00000 n Those costs include increased copay and deductible amounts. 0000031415 00000 n hb``a`` -mY8PE!u[dCC#W6,j.Fvtl,s fb`p;CT3j Log in to get your questions answered by a live representative, Monday through Friday, 6 a.m. to 6:30 p.m. John's annual paycheck deduction for the HSA Plan is zero. Depending the level of PIP you choose, your auto insurer may request a letter stating whether you have qualified health coverage, or QHC. hm6?ZqJ!nv+E Enter the three letters of your "Enrollee ID" found on your Blue Cross Blue Shield member ID card, and then click Go. State Health Plan PPO - Administered by Blue Cross Blue Shield of Michigan (BCBSM). Now let's look at what a single person with relatively few healthcare needs might experience. 0000043394 00000 n 0000027783 00000 n PIP coverage can include items like attendant care, housing modifications and lost wages. For the HSA Plus Plan, Ford contributes $1,000 towards Mary's health savings account, which further reduces her cost to use this plan. 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. Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. (tJ)Dpdd5* 7YG1}[X3C=Yvou*tdU`{NRGqZy3Cv{c.W+5gE|7?)z 248-524-0454 0000029515 00000 n 0000032373 00000 n ^0} SX XD00{03pi`p. Employees can now get a Health Care Plan Verification letter through Wolverine Access by selecting Employee Self-Service > Benefits > Health Care Plan Verification. "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. Healthcare includes your Medical (ASR, BCBS, or HAP), Prescription (Navitus or HAP), Dental (Delta Dental), and Vision (NVA). They are responsible for the out-of-network deductible. 0000048207 00000 n 0000023941 00000 n %PDF-1.6 % [Instructor] Hello, and welcome to Blue Cross Blue Shield of Michigan. 0000006680 00000 n 0 hb``b``f`c`Taa@ V(-) Q>hL)[ley|800pt Pn`K Al@8m@@3J31k=21@=3 F%&hWfpdbm]` Create an account now. Once logged in, navigate to the https://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/no-fault-changes.html <>/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 %PDF-1.7 % 0000016814 00000 n After the deductible and coinsurance are applied for the HSA Plus Plan, James will be responsible for $3,480. 0000024600 00000 n TTY users should call 711. This tool provides side-by-side medical plan comparisons and personalized cost modeling. Let's start with Mary who selected a plan to cover her family. 0000011210 00000 n MSU Student Health Insurance Plan. db4H@g& C You can also take a closer look at your current plan to help you make the best choice for your 2021 plan. {07 N_Bdk 0000029225 00000 n a health reimbursement arrangement which helps members pay for qualified medical expenses. Provided in a vehicle qualified as an ambulance and part of a licensed ambulance operation 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 0000008045 00000 n Uses standard Blue Cross ID card. They won't charge you the difference between their normal charge and the amount paid by the State Health Plan PPO. 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. 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). 0000014332 00000 n 0000007258 00000 n You can keep your unlimited PIP coverage. 0000018138 00000 n Simply . Government Human Resources Benefits Health Benefit Plans. Look for the chat icon at the bottom right corner of the screenon any page of this website. Both plans include a health savings account HSA. 'TMjZ}dM`V;hO0 45o` T@> $0,Tkpp9~#@="-toen7=u-J 3P6sO1v 0IA||$IRs3R6o'j*vU#;B!FL5O,hBtA7|$xVv)*09KTOM8Gh6CAIT,[*6a8 wz 0000023650 00000 n Please review directory information to ensure its accuracy before attesting. Later in the year, that same person needs an MRI and chooses an out-of-network provider. Access commonly requested forms for patient care activities, credentialing, and more. BlueCard Program home page. Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader, Important Information About MedicarePlans. You keep what you dont spend on medical expenses, even if you retire or leave state employment. To help your savings grow even more, when your HSA balance reaches $1,000, you can choose a variety of investments. The document must: 0000019892 00000 n We're making your EOB easier to understand. For more information about the State of Michigan's eligibility requirements for employee health insurance coverage, . 0000008243 00000 n Health Insurance Marketplace Check out information about the Marketplace, especially if you are not eligible for coverage through LCC. 0000015249 00000 n Telemedicine Benefit Summary:Telemedicine visits allow you to meet with a US board-certified doctor online using a video-chat tool. 0000027161 00000 n trailer 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. 0000015914 00000 n He paid the full $800 cost of his medical services because the cost is less than the deductible for either plan. This tool provides side-by-side medical plan comparisons and personalized cost modeling. 866-503-3158 Give us a call to discuss your plan options. Try again later. 0000037572 00000 n This copay is waived if Mary or her family member is admitted as a result of the ER visit. 0000026163 00000 n 500 Renaissance Center. 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 In our next scenario, James covers his wife on his medical plan. 0000048916 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. Qualified health coverage is health or accident insurance that doesn't exclude or limit coverage for injuries from auto accidents. 0000035230 00000 n 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. 0000018397 00000 n You are encouraged to visit your benefit providers' website and create free member logins. (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 endobj *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). If you don't have a Provider Connection account, you will need to register before logging in. %PDF-1.7 % 0000021168 00000 n 0000027316 00000 n Members should direct specific questions about PIP coverage to their auto insurer. %%EOF When we look again at the total cost of having and using the plans, the HSA Plan is the lower cost option for John. 0000013667 00000 n 0000012102 00000 n For Medicare Members: No-fault auto law changes Health (Just Now) WebThere are several ways you can request a QHC letter. What does PIP cover? Member logins offer many on-line tools, such as access to claims information, viewing Explanation of Benefits, printing replacement ID cards, etc. 0000016284 00000 n startxref 0000008674 00000 n Available for commercial, Shared Advantage, and BlueCard. Log in now myfordbenefits.com HELPS YOU: View personalized benefits Representatives are available 8:00 a.m. to 5:00 p.m., Monday through Friday. 0000028854 00000 n 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. To obtain a coordination of benefits letter, call the number on the back of your Enrollee ID card. 0000012767 00000 n 0000017479 00000 n endstream | _1S}9M{T=o9B^>.!a8Znpk9(6_ Your doctor will submit the form by following the instructions on the back. 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. For example: a single person chooses an in-network hospital for surgery. After that deductible is met, out-of-network charges are paid according to the plan design. 0000007421 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. 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. The network covers all 83 Michigan counties and is the largest PPO network in Michigan. i' *eW 0000011869 00000 n And for the HSA Plus Plan, it's $1,020. Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health Please enable JavaScript in your browser for a better user experience. hbbd``b`$WX@]@D0(, IH0@1% b Cu@\v d"3|` \8/$z Contact your auto insurance agent with questions and to learn more about your options. The HSA balance belongs to the employee and can be carried over from year to year. Visit, Go to Qualified Transportation Fringe Benefits (QTFB), Active Employee State Health Plan PPO BCBSM Plan Booklet, Retiree State Health Plan PPO With Medicare Booklet, Understanding HMO Insurance Premium Rates. 0000048834 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. 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
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