0000049165 00000 n 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. We'll accept a qualification form from an office visit that occurred up to 180 days before the start of your plan year. 0000023941 00000 n endobj 0000031798 00000 n 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. Current SHP PPO enrollees will be automatically transitioned with no gap or changes in 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. TVxZOEhL5wV/yZP^',UP1ko}87M@p_[8Sq^R/ 0000006145 00000 n <> This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. The document must: 0 373 0 obj <>stream %PDF-1.6 % Visit Federal No Surprises Act (michigan.gov)for more information. To help your savings grow even more, when your HSA balance reaches $1,000, you can choose a variety of investments. 0000019721 00000 n 0000029515 00000 n Once logged in, navigate to the QHC letter in the Proof of Insurance section at the bottom of the page. Members should direct specific questions about PIP coverage to their auto insurer. After that deductible is met, out-of-network charges are paid according to the plan design. 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. Identified standard preventive services are covered at 100%, but most other services have a 20% in-network coinsurance after meeting the deductible. You can also take a closer look at your current plan to help you make the best choice for your 2021 plan. After your deductible is met, co-insurance applies to medical and prescription costs until your out-of-pocket maximum is met. No-fault auto insurance changes in Michigan bcbsm.com Health (6 days ago) WebThere are several ways you can request a QHC letter. (MSPTA-represented only) 0000027316 00000 n 0000006930 00000 n If you choose to do so, you will be responsible for both deductibles. Click continue to proceed with verification. 577 0 obj <>stream endobj $"mY_%Be66y=\"QI Learn more about your Blue Cross Blue Shield of Michigan plan options. Plan: Blue Care Network (BCN) Premium Cost: Summer 5/16/20 - 8/15/20 $474.00 (approx. 0000022361 00000 n Pontiac, MI 48341. 0000017188 00000 n <>stream What does PIP cover? 0000026478 00000 n Under the new legislation, residents may select different levels of PIP coverage. 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 We appreciate your understanding. XYQ This product provides comprehensive PPO coverage with costsharing features. 0000036168 00000 n 0000039800 00000 n 1200 N. Telegraph Road endstream endobj startxref And he pay $2,280 annually to have the HSA Plus 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 . 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. The out-of-pocket maximum does not include monthly paycheck contributions, copayments, or any expenses not covered by your plan. 0000005625 00000 n 0000030725 00000 n 0000021168 00000 n Let's start with Mary who selected a plan to cover her family. So when we consider the total cost to have and use the plans, the HSA Plus Plan is the less costly option. HSA Plan and HSA Plus Plan. 0000013426 00000 n 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. The plan covers inpatient hospital care, as well as other outpatient services received at a hospital including emergency room care. *Blue Shield of California member plans only, Pre-service review for out-of-area members. 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. Field Service. Now let's look at some helpful scenarios that show how these plans work, considering the costs to have and use each plan. Reviewplan materialscarefully to understand the advantages and risks associated with the plan. If you have any questions, call the phone number on the back of your Blue Cross ID card and we'll help. 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 Detroit, MI 48226-9942. This means you have the option to increase your payroll contributions so you can reach the maximum contribution amount earlier in the year. Ready to enroll? 0000058981 00000 n California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. As you can see, there are great benefits to having an HSA. {07 N_Bdk 0000010919 00000 n endstream endobj 14 0 obj <. To request your QHC confirmation letter: Log in to your member account. The network covers all 83 Michigan counties and is the largest PPO network in Michigan. 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. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. 0000028562 00000 n 0000018397 00000 n You can log in to your online member account to see if you have a QHC letter to download. Don't have a member account? You still have the freedom to go out-of-network to see any physician, hospital or other provider of your choice. When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. Healthcare includes your Medical (ASR, BCBS, or HAP), Prescription (Navitus or HAP), Dental (Delta Dental), and Vision (NVA). 0000048834 00000 n 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. Follow the instructions on the page to have your letter created. The State Health Plan PPO provides reimbursement for medical care expenses when you need treatment for an illness, injury, or disease. 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. 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. You can log in to your online member account to see if you have a QHC letter to download. 0000044573 00000 n 0000059656 00000 n Or, call the number on the back of your member ID card. 0000016814 00000 n Once logged in, navigate to the https://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/no-fault-changes.html Please review directory information to ensure its accuracy before attesting. `+DO>|5%Nqdws=0y';L a66[OIe,%EqtRS&54Qvw"E$iu3:G+x+II^ UTT"9W!4XuYS6Ly}l&!2 John's annual paycheck deduction for the HSA Plan is zero. Please provide the following information about the policy holder of the other health coverage. 0000008446 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. For the HSA Plus Plan, her yearly contributions, which is her cost to have the plan would be $3,300. 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 . 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. &yw}.$7eIw We provide health insurance in Michigan. 93gpm},|P gaToY%+IzO96`%n'`Pll@BJa 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"). The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. In our next scenario, James covers his wife on his medical plan. Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. 0000031415 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. Your coverage is considered qualified if it: When making a decision, keep in mind that PIP has coverage that goes beyond traditional health insurance. 0000007421 00000 n If you absolutely need to call, please try again at a later date. Representatives are available 8:00 a.m. to 5:00 p.m., Monday through Friday. 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. This tool provides side-by-side medical plan comparisons and personalized cost modeling. startxref If you are new to an HMO, that HMO may ask you to select your primary care physician. For Medicare Members: No-fault auto law changes bcbsm.com Health (Just Now) WebThere are several ways you can request a QHC letter. You can choose your own primary care physician who will provide direct care or make referrals from within the network. .r~'J ms-oA&@i 9k2 J4T{Yt;cu6J_Fs"6r|(Z? New SHP PPO membership ID cards will be mailed in September 2019. 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. 0000049042 00000 n 0000011210 00000 n 0000004937 00000 n Blue Cross Blue Shield of Michigan: Understanding member ID cards An important note regarding the State Health Plan PPO deductibles: You have the freedom to see both in-network and out-of-network providers. Create an account now. 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 California Physicians Service DBA Blue Shield of California 1999-2023. For example: a single person chooses an in-network hospital for surgery. hb```5,|z cbD{600T|txGyG{T8"W3\baah4p1$$ v3Kx4@6@ 1 0000027625 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. N'JV|DI]Ea:%*&[|{;z^HzwD/L_d?D/q|',W2tKpcukU;Bxc%w37XeNh{%_hl@zPMy * uAd;{i6pmn'D=6e Cvy"ngpdh6 s/8bG. 0000025874 00000 n 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. The HSA balance belongs to the employee and can be carried over from year to year. %%EOF Health Trust 0000015914 00000 n 0000016573 00000 n You can call the number on the back of your member ID card. 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 $3,006 out of pocket to use this plan. To find the most up-to-date information about current medical and pharmacy claims, you can use the Blue Cross app or log into your BCBSM member account at bcbsm.com. All rights reserved. 0000011580 00000 n Blue Cross Blue Shield of Michigan. It can help treat minor illnesses such as colds, sinus or respiratory infections, sprains, or rashes, making it perfect when your primary care physician is unavailable or leaving the house is difficult. }v".VrTAmk$NJ+ y{i-Y#gds7D Preventive care benefits are covered 100 percent when received from a TRUST PPO network provider. hbbd``b`$WX@]@D0(, IH0@1% b Cu@\v d"3|` 0000025213 00000 n 0000027945 00000 n 0000043394 00000 n %PDF-1.7 % b|=b}#Aif3TRD0;@NHkQ#`VEQxD 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. Take a look at what Blue Cross plans offer, then choose the one that's right for you. Both plans include a health savings account HSA. "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. 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. Individuals attempting unauthorized access will be prosecuted. 0000014991 00000 n 0000048173 00000 n 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. Utilize the Insurance Planspage to review plan summaries or contact the HMO that interests you to request their benefit booklet. 0000005441 00000 n To file a Blue Cross Blue Shield Global Core eClaim online, log in with your username and password or register for access. Be informed about all your Blue Cross plan has to offer. 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. SM. 1tv Physician Qualification Form (PDF) Healthy Blue Achieve Form This provides cost and other information related to your plan options. hb``a`` -mY8PE!u[dCC#W6,j.Fvtl,s fb`p;CT3j 13 0 obj <> endobj The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. 0000029225 00000 n 0000029999 00000 n SECTION 2 OTHER HEALTH COVERAGE INFORMATION . 0000034448 00000 n 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. 0000000016 00000 n 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). There are several ways you can request a QHC letter. | _1S}9M{T=o9B^>.!a8Znpk9(6_ After the deductible and coinsurance are applied for the HSA Plus Plan, James will be responsible for $3,480. Give us a call to discuss your plan options. Provided in a vehicle qualified as an ambulance and part of a licensed ambulance operation h1aMXk* Q)DDJjH$*F \8/$z 0000018138 00000 n 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. An HDHP offers a lower biweekly premium in exchange for higher deductibles and out-of-pocket limits. Depending the level of PIP you choose, your auto insurer may request a letter stating whether you have qualified health coverage, or QHC. 0000021696 00000 n 0000027006 00000 n Access commonly requested forms for patient care activities, credentialing, and more. State Health Plan PPO - Administered by Blue Cross Blue Shield of Michigan (BCBSM). Health Insurance Marketplace Check out information about the Marketplace, especially if you are not eligible for coverage through LCC. The account and money are yours. 0000014332 00000 n What's qualified health coverage under the new law? 600 Lafayette East. 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). endstream endobj startxref db4H@g& C And with the HSA Plus Plan, Ford will also contribute to your HSA. Contact your auto insurance agent with questions and to learn more about your options. 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. Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. Select Claims on the menu bar. Enter the three letters of your "Enrollee ID" found on your Blue Cross Blue Shield member ID card, and then click Go. For Medicare Members: No-fault auto law changes Health (Just Now) WebThere are several ways you can request a QHC letter. This tool provides side-by-side medical plan comparisons and personalized cost modeling. 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. <. 0000034485 00000 n To get reimbursed for a flu or pneumonia shot, you'll need to fill out our Member Flu and Pneumonia Shots Reimbursement Form (PDF). They won't charge you the difference between their normal charge and the amount paid by the State Health Plan PPO. State and Federal Privacy laws prohibit unauthorized access to Member's private information. Because Mary's cost to have the HSA Plan is $0, her total cost is $3,030. For auto insurance policies issued or renewed after July 1, 2020, Michigan's Automobile No-Fault Insurance Law will change. You're now aware you have a choice between two HSA eligible medical plans in 2021. 0rtq]%g=z.#i0\*m(D2q;t2}$kX[-+G-0hdA9r*8!jcsfEdRyV0=bLzf']q[6F"h.wB)^wvDH =/OC; f'e$GVi]G}//xTw)9]y(kkxU*uXT) 0ajx[k jK`8P1(GU=. This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. 800-229-2210 IS IBCQ-]97T5dUa{ugdcg`\o'.Nu }n|7G|ZXXMf9I\RTt K{d\H3$]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. Behavior Health/Substance Use Disorder Administrator. 866-503-3158 0000036634 00000 n Visit myfordbenefits.com and make your plan selection for 2023. 258 0 obj <> endobj View detailed plan information in this document. endobj BlueCard Program home page. 0000008674 00000 n Let's say Mary and her family have a normal year with normal doctor visits. They are responsible for the out-of-network deductible. 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. Questions About Your Benefits? 0000048207 00000 n 0000014041 00000 n 500 Renaissance Center. Once they've been met, the plan generally pays the full amount of your in-network medical and prescription costs. %PDF-1.7 % 0000009279 00000 n Demographics |Electronic Data Interchange (EDI) | Recoveries, Need help with Provider Connection: Blue Shield Provider Connection Guide Provider Connection training. Simply Blue. In the HSA Plus Plan, you're also responsible for all medical and prescription costs until your deductible is met.
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