endobj Identified standard preventive services are covered at 100%, but most other services have a 20% in-network coinsurance after meeting the deductible. Enroll when you're ready. With the total of all her family services and prescriptions, the HSA Plan costs $3,030 to use. 0000032096 00000 n (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 119 0 obj You may look up HMOs in your residential area using the zip code tool. 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. Create an account now. And you don't have to use the money by the end of the year, your account balance will not expire. When we look again at the total cost of having and using the plans, the HSA Plan is the lower cost option for John. endstream 0000031798 00000 n 120 0 obj 0000013667 00000 n 0000045752 00000 n Blue Cross Blue Shield of Michigan, in partnership with Lucet This amount does not count toward the plan's out-of-pocket maximum. | _1S}9M{T=o9B^>.!a8Znpk9(6_ 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. 0000058981 00000 n 0000048409 00000 n 0000025504 00000 n Click My Plan and Spending. James has arthritis, so he needs to take a higher cost maintenance drug. 0000020798 00000 n 0000048540 00000 n 0000042215 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. Be sure to turn off pop-up blocker and private browsing prior to opening your Auto Health verification letter. When you combine Mary's cost to have and use the HSA Plus Plan, her total cost is $5,306. Federal No Surprises Act: The federal government issued the "transparency in coverage" final rule under the Federal No Surprises Act. 0000014702 00000 n Respond promptly to the carrier to complete the final phase of the enrollment process. If you absolutely need to call, please try again at a later date. To help you compare and select your 2021 plan based on your personal needs, Ford has provided Benefits Mentor powered by IBM Watson Health. 0000007258 00000 n Your explanation of benefits (EOB) statement has a new look. You are encouraged to visit your benefit providers' website and create free member logins. 0000013426 00000 n This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. 0000005259 00000 n You have certain tasks to complete within specific . 0000047030 00000 n 0000030725 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 yourhealth carrier. 0000003382 00000 n Let's start with Mary who selected a plan to cover her family. 0000048277 00000 n 0000048683 00000 n 0000012476 00000 n The out-of-pocket maximum does not include monthly paycheck contributions, copayments, or any expenses not covered by your plan. 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 You may enroll in an authorized HMO plan serving your residential area. 0000025874 00000 n 0000008045 00000 n Contact your auto insurance agent with questions and to learn more about your options. Ford offers an accelerated contribution option. The maximum deductible for two or more covered persons in your family was limited to 1 months of your basic salary. The HSA Plus Plan requires a monthly contribution that's different depending on whether the plan will cover you, you and your spouse, you and your children, or your entire family. 500 Renaissance Center. If you have any questions, call the phone number on the back of your Blue Cross ID card and we'll help. 93gpm},|P gaToY%+IzO96`%n'`Pll@BJa 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. 0000038624 00000 n The web Browser you are currently using is unsupported, and some features of this site may not work as intended. Detroit, MI 48243. Michigans new auto no-fault insurance law went into effect July 1, 2020. 0000010306 00000 n Be informed about all your Blue Cross plan has to offer. 0000023941 00000 n lo%x9d,oqM lzgw'TK6oB~+d; {qi.B/ R`]Hcq6~s_]=y&|9]Fl2b\o9Vp"(5Z9lb.dx;@? *Mii lkSW+0XI~'kT`C>?wlvR lC]n8\! 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). For the best experience, use the latest version of Google Chrome or Microsoft Edge. 0000048613 00000 n You can also opt-out if you qualify for that provision. 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. 0000048916 00000 n <>stream 141 0 obj 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. XYQ This product provides comprehensive PPO coverage with costsharing features. To obtain a coordination of benefits letter, call the number on the back of your Enrollee ID card. 0000036634 00000 n Contact your auto insurance carrier for specific questions regarding PIP coverage. 0000048349 00000 n 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. California Physicians Service DBA Blue Shield of California 1999-2023. After your deductible is met, co-insurance applies to medical and prescription costs until your out-of-pocket maximum is met. 0000007628 00000 n It has a deductible of $6,000 or less per person. The HSA balance belongs to the employee and can be carried over from year to year. If you choose to do so, you will be responsible for both deductibles. The plan covers inpatient hospital care, as well as other outpatient services received at a hospital including emergency room care. 0000049102 00000 n 0000027945 00000 n If you have additional BCBSM contracts, pleas e include this as other coverage. 0 trailer Now let's imagine Mary and her family had a year with a lot of medical and prescription expenses where they meet the out-of-pocket maximum for both plans. 0000027161 00000 n Two letters confirming you have MESSA coverage that are often requested by your auto insurance carrier can be found in your MyMESSA member account. If you're asked to provide your auto insurer with a QHC letter, you will either need to contact your health plan (like Blue Cross) or your employer to request the letter. 1200 N. Telegraph Road Please see below for further information. 0000014332 00000 n 0000018138 00000 n The only providers permitted to submit a signed "Hospital Coverage Letter" for hospital privileges' requirement, are the following provider specialties/types: Adolescent Medicine, Child & Adolescent Psychiatry, Developmental-Behavioral Pediatrics, Family Practice, General Practice, Geriatric Medicine, Internal Medicine, Pediatrics, Physical 0000005858 00000 n 0rtq]%g=z.#i0\*m(D2q;t2}$kX[-+G-0hdA9r*8!jcsfEdRyV0=bLzf']q[6F"h.wB)^wvDH =/OC; f'e$GVi]G}//xTw)9]y(kkxU*uXT) 0ajx[k jK`8P1(GU=. Enter the three letters of your "Enrollee ID" found on your Blue Cross Blue Shield member ID card, and then click Go. There are different levels of PIP coverage that you can choose from. 0000026320 00000 n For auto insurance policies issued or renewed after July 1, 2020, Michigan's Automobile No-Fault Insurance Law will change. hb``b``f`c`Taa@ V(-) Q>hL)[ley|800pt Pn`K Al@8m@@3J31k=21@=3 F%&hWfpdbm]` N'JV|DI]Ea:%*&[|{;z^HzwD/L_d?D/q|',W2tKpcukU;Bxc%w37XeNh{%_hl@zPMy * uAd;{i6pmn'D=6e Cvy"ngpdh6 s/8bG. This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. #G:&#WeKo]b287X]4 fd!n>X3jG[)GW%0.{1,JqA]Vf,fyf#Ji+OvDUpe!K|\"e2{g3ePW?/p An HSA is a smart way to save for your future qualified health expenses, including those that may come up in retirement. BlueCard Program home page. As you can see, there are great benefits to having an HSA. See below. Field Service. We're making your EOB easier to understand. 0000048173 00000 n For all other claims, choose your health plan on this page to find the form and instructions for sending it in. You can also take a closer look at your current plan to help you make the best choice for your 2021 plan. Mail Code 1112. 0000009279 00000 n We appreciate your understanding. Callers to our phone lines are currently experiencing long wait times. \8/$z Telemedicine Benefit Summary:Telemedicine visits allow you to meet with a US board-certified doctor online using a video-chat tool. }v".VrTAmk$NJ+ y{i-Y#gds7D 0000023276 00000 n 0000017849 00000 n Employees can also make pre-tax HSA contributions by payroll deductions. 0000014991 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. SECTION 2 OTHER HEALTH COVERAGE INFORMATION . a health reimbursement arrangement which helps members pay for qualified medical expenses. We'll accept a qualification form from an office visit that occurred up to 180 days before the start of your plan year. The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. Health Trust 0000017479 00000 n Please enable JavaScript in your browser for a better user experience. Providers and facilities that fail to comply will be suppressed from our directories. 0000059965 00000 n 0000022731 00000 n b|=b}#Aif3TRD0;@NHkQ#`VEQxD 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. 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 Ready to enroll? General Inquiries. <> 0000010017 00000 n endobj em4MVRpH ~*.V%s^5h}R,uJXP;6s@bH{{J 4aWS8r *W~oKMwSV-Kl^voIb #TY^hAP38HUR{mv8azF`lAQm8yiKm77!}1nW startxref 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). 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. 0000009647 00000 n Learn more about your Blue Cross Blue Shield of Michigan plan options. We're sorry, but the attestation service is temporarily unavailable. 0000007848 00000 n 0000028187 00000 n Both plans offer the largest doctor and hospital network as well as benefits, including prescription drug coverage and in-network preventive care at no additional cost. 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. You don't need to wait until your new plan year starts to see your doctor. 1tv They are responsible for the out-of-network deductible. 0 1-313-225-9000. 0000029225 00000 n i' *eW For more information about the State of Michigan's eligibility requirements for employee health insurance coverage, . 0000018397 00000 n You can call the number on the back of your member ID card. Both plans include a health savings account HSA. For the HSA Plus Plan, her yearly contributions, which is her cost to have the plan would be $3,300. Thank you for viewing. Once logged in, navigate to the https://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/no-fault-changes.html Visit Federal No Surprises Act (michigan.gov)for more information. Visit, Go to Qualified Transportation Fringe Benefits (QTFB), Active Employee State Health Plan PPO BCBSM Plan Booklet, Retiree State Health Plan PPO With Medicare Booklet, Understanding HMO Insurance Premium Rates. Questions About Your Benefits? This contribution will be prorated for employees who enroll mid-year. 0000027006 00000 n 0000043394 00000 n An HMO is a managed care plan that provides medical care through its network of physicians, pharmacies, contracted hospitals, and medical care suppliers. All rights reserved. *Blue Shield of California member plans only, Pre-service review for out-of-area members. Learnyour requirements, deadline dates and more about your coverage. hbbd``b`$WX@]@D0(, IH0@1% b Cu@\v d"3|` For Medicare Members: No-fault auto law changes bcbsm.com Health (Just Now) WebThere are several ways you can request a QHC letter. Reviewplan materialscarefully to understand the advantages and risks associated with the plan. 0000015249 00000 n Simply Blue. 193 0 obj <>stream 0000024311 00000 n 0000005441 00000 n Utilize the Insurance Planspage to review plan summaries or contact the HMO that interests you to request their benefit booklet. 0000021457 00000 n Even though this law has to do with your auto insurance, a lot of people have questions about what it means for your. endobj Physician Qualification Form (PDF) Healthy Blue Achieve Form 0000013137 00000 n 0000014041 00000 n 0000015914 00000 n You must be in pay status to receive this payment. To request your QHC confirmation letter: Log in to your member account. Because Mary's cost to have the HSA Plan is $0, her total cost is $3,030.
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