#G:&#WeKo]b287X]4 fd!n>X3jG[)GW%0.{1,JqA]Vf,fyf#Ji+OvDUpe!K|\"e2{g3ePW?/p For Medicare Members: No-fault auto law changes bcbsm.com Health (Just Now) WebThere are several ways you can request a QHC letter. {07 N_Bdk Effective January 1, 2023, MSPTA-represented (To1) employees are eligible for this benefit, DROP employees and OEAIs and the dependents remain ineligible. endobj To help you compare and select your 2021 plan based on your personal needs, Ford has provided Benefits Mentor powered by IBM Watson Health. 0000049042 00000 n This plan didn't cover prescription charges, office visit charges, medical equipment, psychiatric services, or other major medical services. 0000010306 00000 n Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. Visit myfordbenefits.com and make your plan selection for 2023. TVxZOEhL5wV/yZP^',UP1ko}87M@p_[8Sq^R/ Representatives are available 8:00 a.m. to 5:00 p.m., Monday through Friday. 0000011210 00000 n 0000021696 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 Because Mary's cost to have the HSA Plan is $0, her total cost is $3,030. Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. 0000030241 00000 n hb``a`` -mY8PE!u[dCC#W6,j.Fvtl,s fb`p;CT3j 0000023020 00000 n 0000000016 00000 n 0000060102 00000 n Select Claims on the menu bar. James wouldn't have to pay anything from his paycheck to have the HSA Plan. The web Browser you are currently using is unsupported, and some features of this site may not work as intended. 0000006680 00000 n Enroll when you're ready. This is the amount taken from your pay each month. 0000024311 00000 n 0000020133 00000 n 0000045752 00000 n Please review directory information to ensure its accuracy before attesting. Provided in a vehicle qualified as an ambulance and part of a licensed ambulance operation 0rtq]%g=z.#i0\*m(D2q;t2}$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=. Your Benefit Guide State Health Plan PPO 3 Visit BCBSM Customer Service Center 232 S. Capitol Ave. Lansing, MI 48933 . Links to all provider websites can be found on our Benefit Carrier Contact Information page. 'TMjZ}dM`V;hO0 45o` T@> $0,Tkpp9~#@="-toen7=u-J 3P6sO1v 0IA||$IRs3R6o'j*vU#;B!FL5O,hBtA7|$xVv)*09KTOM8Gh6CAIT,[*6a8 wz Log in to continue with member verification. This copay is waived if Mary or her family member is admitted as a result of the ER visit. 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? 0000014991 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. PIP pays for services that health insurance may or may not cover. Don't have a member account? These plans also allow you to set aside tax-free funds that you can use for qualified medical expenses. 0000048683 00000 n There are several ways you can request a QHC letter. 0000017849 00000 n 0000019892 00000 n [Narrator] Hello again, and welcome to Blue Cross Blue Shield of Michigan. 0000007258 00000 n 0000021168 00000 n If you need information about eligibility, benefits or claims, or want to submit or review an authorization, the best way to get up-to-date information is through our on-line resources. If you don't have a Provider Connection account, you will need to register before logging in. And he pay $2,280 annually to have the HSA Plus Plan. The out-of-pocket maximum does not include monthly paycheck contributions, copayments, or any expenses not covered by your plan. For the best experience, use the latest version of Google Chrome or Microsoft Edge. 0000048834 00000 n endstream endobj 14 0 obj <. This tool provides side-by-side medical plan comparisons and personalized cost modeling. Federal No Surprises Act: The federal government issued the "transparency in coverage" final rule under the Federal No Surprises Act. 0000004148 00000 n California Physicians Service DBA Blue Shield of California 1999-2023. Even though this law has to do with your auto insurance, a lot of people have questions about what it means for your. XYQ This product provides comprehensive PPO coverage with costsharing features. 866-503-3158 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. To obtain a coordination of benefits letter, call the number on the back of your Enrollee ID card. 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 . Benefits under this plan were payable only after you had paid expenses equal to one month's basic salary (your deductible). 0000005858 00000 n 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. And you don't have to use the money by the end of the year, your account balance will not expire. To file a Blue Cross Blue Shield Global Core eClaim online, log in with your username and password or register for access. Please enable JavaScript in your browser for a better user experience. The account and money are yours. You can call the number on the back of your member ID card. Health Insurance Marketplace Check out information about the Marketplace, especially if you are not eligible for coverage through LCC. Follow the instructions on the page to have your letter created. Under the plan documents section, click Michigan Auto Reform to request a letter be mailed to the subscriber's address. 0000048409 00000 n 0000010017 00000 n Simply Blue. Questions About Your Benefits? Give us a call to discuss your plan options. 0000009647 00000 n Those costs include increased copay and deductible amounts. 0000048540 00000 n 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). 0000014702 00000 n 0000016814 00000 n You can also review your current plan to help make the best choice for 2021. 0000036634 00000 n 0000031798 00000 n Blue Cross Blue Shield of Michigan. 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. endstream 140 0 obj <> endobj 0000059965 00000 n And with the HSA Plus Plan, Ford will also contribute to your HSA. Telemedicine Benefit Summary:Telemedicine visits allow you to meet with a US board-certified doctor online using a video-chat tool. endobj Other costs to use the HSA Plan will vary depending on whether you select plan coverage for you or for your family. *Blue Shield of California member plans only, Pre-service review for out-of-area members. %%EOF 0000012476 00000 n %PDF-1.6 % SM. Let's start with Mary who selected a plan to cover her family. For more information about the State of Michigan's eligibility requirements for employee health insurance coverage, . 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 $6,000 or less per individual, Or if your coverage is Medicare Parts A & B. You can log in to your online member account to see if you have a QHC letter to download. To get reimbursed for a flu or pneumonia shot, you'll need to fill out our Member Flu and Pneumonia Shots Reimbursement Form (PDF). We provide health insurance in Michigan. 0000027625 00000 n 0000008905 00000 n Be sure to turn off pop-up blocker and private browsing prior to opening your Auto Health verification letter. Your explanation of benefits (EOB) statement has a new look. 0000024600 00000 n 0000048613 00000 n endstream 0000032373 00000 n Mary would pay nothing from her paycheck to have the HSA Plan. \8/$z 0000023941 00000 n When you combine Mary's cost to have and use the HSA Plus Plan, her total cost is $5,306. The network covers all 83 Michigan counties and is the largest PPO network in Michigan. 0000027473 00000 n 0000017188 00000 n 0000021457 00000 n Employees can also make pre-tax HSA contributions by payroll deductions. For all other claims, choose your health plan on this page to find the form and instructions for sending it in. 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. You can choose your own primary care physician who will provide direct care or make referrals from within the network. *Blue Shield of California member plans only. Click continue to proceed with verification. 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. 0000060222 00000 n 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. Now let's look at some helpful scenarios that show how these plans work, considering the costs to have and use each plan. Demographics |Electronic Data Interchange (EDI) | Recoveries, Need help with Provider Connection: Blue Shield Provider Connection Guide Provider Connection training. An HMO is a managed care plan that provides medical care through its network of physicians, pharmacies, contracted hospitals, and medical care suppliers. When asked to log in, choose Continue as a guest. Visit Federal No Surprises Act (michigan.gov)for more information. Government Human Resources Benefits Health Benefit Plans. You can also opt-out if you qualify for that provision. 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. 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 . 0000049102 00000 n 0000020798 00000 n Blue Cross Blue Shield of Michigan, in partnership with Lucet 0000028562 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. 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. h1aMXk* Q)DDJjH$*F This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. You may enroll in an authorized HMO plan serving your residential area. Look for the chat icon at the bottom right corner of the screenon any page of this website. 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. 0000025504 00000 n Go paperless by submitting claims and managing payments online for free. James has arthritis, so he needs to take a higher cost maintenance drug. It has more than 20,000 physicians, including specialists, and more than 140 all acute care hospitals in Michigan. 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. Your doctor will submit the form by following the instructions on the back. 373 0 obj <>stream Available for commercial, Shared Advantage, and BlueCard. You may look up HMOs in your residential area using the zip code tool. 0000029515 00000 n Simply . 0 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. See your 2023 Benefits-at-a-Glance (PDF) for more plan details. 0000035745 00000 n Both plans include a health savings account HSA. 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. (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 We're redirecting you to Blue Shield of California's Find a doctor search. First, let's look at the cost to have a medical plan. 0000014332 00000 n 0000022070 00000 n Field Service. Preventive care benefits are covered 100 percent when received from a TRUST PPO network provider. 119 0 obj hbbd```b``z"@$D2e5A$)e,H^0 The Plan also covers most of your community-based care (office visits), as well as necessary medical equipment and supplies (crutches, hearing aids, etc.). xref 0000048173 00000 n Log in to get your questions answered by a live representative, Monday through Friday, 6 a.m. to 6:30 p.m. Submit and confirm authorizations and approval of medical and pharmacy services prior to services being rendered. 0000010919 00000 n You are encouraged to visit your benefit providers' website and create free member logins. 0000048976 00000 n Blue Cross Blue Shield of Michigan: Understanding member ID cards %PDF-1.6 % 0000044573 00000 n He paid the full $800 cost of his medical services because the cost is less than the deductible for either plan. 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. If you have additional BCBSM contracts, pleas e include this as other coverage. "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. 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 0000058981 00000 n 0000031112 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 This provides cost and other information related to your plan options. 0000011869 00000 n <>stream 0000027006 00000 n 0000048207 00000 n 0000004937 00000 n Once they've been met, the plan generally pays the full amount of your in-network medical and prescription costs. <<674A7177E0417F4590EC384E93D00AED>]>> 0000025874 00000 n 0000029225 00000 n Learn more about your Blue Cross Blue Shield of Michigan plan options. Access tools to prescreen, submit and check the status of submitted claims. Per state and federal law, providers and facilities must attest to accuracy of directory information to stay visible in find a Doctor. Thank you for viewing. 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. 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. 0000015914 00000 n For the HSA Plus Plan, Ford contributes $1,000 towards Mary's health savings account, which further reduces her cost to use this plan. 0000018771 00000 n What does PIP cover? You don't need to wait until your new plan year starts to see your doctor. %PDF-1.6 % 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. This contribution will be prorated for employees who enroll mid-year. SECTION 2 OTHER HEALTH COVERAGE INFORMATION . 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. 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. Members should direct specific questions about PIP coverage to their auto insurer. They won't charge you the difference between their normal charge and the amount paid by the State Health Plan PPO. Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health Here's how these plans work. 141 0 obj 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 the HSA Plus Plan, her yearly contributions, which is her cost to have the plan would be $3,300. Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader, Important Information About MedicarePlans. They are responsible for the out-of-network deductible. You can log in to your online member account to see if you have a QHC letter to download. An HDHP offers a lower biweekly premium in exchange for higher deductibles and out-of-pocket limits. 0000003382 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. 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. 0000014041 00000 n %%EOF Later in the year, that same person needs an MRI and chooses an out-of-network provider. If you choose to do so, you will be responsible for both deductibles. 0000008446 00000 n 258 0 obj <> endobj Mail Code 1112. %PDF-1.7 % This tool provides side-by-side medical plan comparisons and personalized cost modeling. They areresponsible for the deductible, then the hospital is reimbursed according to the plan design. 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. 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. 0000032777 00000 n 0000059887 00000 n 0000005625 00000 n Let's say Mary and her family have a normal year with normal doctor visits. 1tv After that deductible is met, out-of-network charges are paid according to the plan design. 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 0000033229 00000 n 13 0 obj <> endobj $"mY_%Be66y=\"QI 0000026848 00000 n 120 0 obj Learn about our tools and how to use them in our upcoming webinars. 0000051836 00000 n With the total of all her family services and prescriptions, the HSA Plan costs $3,030 to use. The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. 0000026163 00000 n 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. The State Health Plan PPO provides reimbursement for medical care expenses when you need treatment for an illness, injury, or disease. 0000003914 00000 n Member logins offer many on-line tools, such as access to claims information, viewing Explanation of Benefits, printing replacement ID cards, etc. 0000029999 00000 n The maximum deductible for two or more covered persons in your family was limited to 1 months of your basic salary. PIP coverage can include items like attendant care, housing modifications and lost wages. 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. To request your QHC confirmation letter: Log in to your member account. The plan covers inpatient hospital care, as well as other outpatient services received at a hospital including emergency room care. Be informed about all your Blue Cross plan has to offer. 0000028854 00000 n 0000026478 00000 n 0000027945 00000 n 0000059434 00000 n To help your savings grow even more, when your HSA balance reaches $1,000, you can choose a variety of investments. The network covers all 83 Michigan counties and is the largest PPO network in Michigan. Please refer to www.bcbsm.com/som for the list of providers. Contact your auto insurance agent with questions and to learn more about your options. 0000023650 00000 n 1-313-225-9000. 0000030483 00000 n As you can see, there are great benefits to having an HSA. | _1S}9M{T=o9B^>.!a8Znpk9(6_ We'll accept a qualification form from an office visit that occurred up to 180 days before the start of your plan year. 0000022731 00000 n The HSA balance belongs to the employee and can be carried over from year to year. PIP is the part of an auto insurance plan that covers the health care costs from a car . Access commonly requested forms for patient care activities, credentialing, and more. Click My Plan and Spending. So when we consider the total cost to have and use the plans, the HSA Plus Plan is the less costly option. db4H@g& C This copay does not apply to the out of pocket maximum for the HSA Plan, so Mary will be responsible for this copay each time she or a family member visits the ER, after the deductible is met. 0000032096 00000 n Automobile No-Fault Insurance Changes: Prior to July 2, 2020, Michigans Automobile No-Fault Insurance Law required individuals to purchase unlimited Personal Injury Protection (PIP) through their auto insurer. Michigans new auto no-fault insurance law went into effect July 1, 2020. John's annual paycheck deduction for the HSA Plan is zero. startxref IS IBCQ-]97T5dUa{ugdcg`\o'.Nu }n|7G|ZXXMf9I\RTt K{d\H3$]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. 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 0000011580 00000 n Current SHP PPO enrollees will be automatically transitioned with no gap or changes in coverage. Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. In 2021, you'll have a choice between two HSA eligible medical plans, HSA Plan and HSA Plus Plan. Claims | Benefits | Member eligibility | How to use Provider Connection | Contracts | Credentialing | It has a deductible of $6,000 or less per person. 0000004052 00000 n All rights reserved. Qualified Transportation Fringe Benefits (QTFB). $158 per month) Eligibility: All MSU students, Law students, Visiting scholars, and more, including spouse and children of a student enrolled in the plan.
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