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. Look for the chat icon at the bottom right corner of the screenon any page of this website. You have certain tasks to complete within specific . The Plan also covers most of your community-based care (office visits), as well as necessary medical equipment and supplies (crutches, hearing aids, etc.). 0000026660 00000 n See below. endstream Please review directory information to ensure its accuracy before attesting. 0000030483 00000 n %%EOF 0000048540 00000 n Members enrolled in the HSA plan will be responsible for paying an ER copayment after the deductible has been met. #G:&#WeKo]b287X]4 fd!n>X3jG[)GW%0.{1,JqA]Vf,fyf#Ji+OvDUpe!K|\"e2{g3ePW?/p 0000020507 00000 n 1-313-225-9000. Michigans new auto no-fault insurance law went into effect July 1, 2020. 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. James has arthritis, so he needs to take a higher cost maintenance drug. Respond promptly to the carrier to complete the final phase of the enrollment process. 0000023941 00000 n \8/$z .r~'J ms-oA&@i 9k2 J4T{Yt;cu6J_Fs"6r|(Z? 120 0 obj Try again later. Click continue to proceed with verification. 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. What does PIP cover? Log in to get your questions answered by a live representative, Monday through Friday, 6 a.m. to 6:30 p.m. You can also review your current plan to help make the best choice for 2021. Your doctor will submit the form by following the instructions on the back. The HSA Plan is available to you at no cost. When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. Contact your auto insurance carrier for specific questions regarding PIP coverage. This means you have the option to increase your payroll contributions so you can reach the maximum contribution amount earlier in the year. <> 0000014332 00000 n 13 0 obj <> endobj 0000021696 00000 n 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. 0000048472 00000 n <. db4H@g& C 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? 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. Access commonly requested forms for patient care activities, credentialing, and more. SECTION 2 OTHER HEALTH COVERAGE INFORMATION . Log in to continue with member verification. 0 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. Employees can also make pre-tax HSA contributions by payroll deductions. Field Service. 0000027473 00000 n 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. You keep what you dont spend on medical expenses, even if you retire or leave state employment. 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. 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. Pontiac, MI 48341. PIP coverage can include items like attendant care, housing modifications and lost wages. 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. Be informed about all your Blue Cross plan has to offer. 0000048834 00000 n Learnyour requirements, deadline dates and more about your coverage. Enter the three letters of your "Enrollee ID" found on your Blue Cross Blue Shield member ID card, and then click Go. 0000029757 00000 n He paid the full $800 cost of his medical services because the cost is less than the deductible for either plan. "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. Ready to enroll? We're redirecting you to Blue Shield of California's Find a doctor search. Your email address will not be published. <>stream Questions About Your Benefits? 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). This copay is waived if Mary or her family member is admitted as a result of the ER visit. They are responsible for the out-of-network deductible. 0000035745 00000 n Under the new legislation, residents may select different levels of PIP coverage. Benefits under this plan were payable only after you had paid expenses equal to one month's basic salary (your deductible). Blue Shield/Blue Shield Promise network referrals. 0000049042 00000 n With the total of all her family services and prescriptions, the HSA Plan costs $3,030 to use. 0000036168 00000 n 0000041020 00000 n 0000015249 00000 n PIP is the part of an auto insurance plan that covers the health care costs from a car . 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. 0000008674 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 $158 per month) Eligibility: All MSU students, Law students, Visiting scholars, and more, including spouse and children of a student enrolled in the plan. You can choose your own primary care physician who will provide direct care or make referrals from within the network. 373 0 obj <>stream There are several ways you can request a QHC letter. 1tv For more information about the State of Michigan's eligibility requirements for employee health insurance 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). 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. Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health Members should direct specific questions about PIP coverage to their auto insurer. 0000038624 00000 n 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. 0000012102 00000 n xref Access tools to prescreen, submit and check the status of submitted claims. 0000026163 00000 n 0000014702 00000 n An HDHP offers a lower biweekly premium in exchange for higher deductibles and out-of-pocket limits. For all other claims, choose your health plan on this page to find the form and instructions for sending it in. Let's start with Mary who selected a plan to cover her family. Contact your auto insurance agent with questions and to learn more about your options. For the best experience, use the latest version of Google Chrome or Microsoft Edge. Depending the level of PIP you choose, your auto insurer may request a letter stating whether you have qualified health coverage, or QHC. You can log in to your online member account to see if you have a QHC letter to download. 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. These plans also allow you to set aside tax-free funds that you can use for qualified medical expenses. 0000011210 00000 n Create an account now. 0000023276 00000 n View the eGuide to see the Ford resources available all year long. 0000014991 00000 n 0000012767 00000 n 0000005858 00000 n 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. 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. 0000027625 00000 n <>/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 Learn more about your Blue Cross Blue Shield of Michigan plan options. After the deductible and coinsurance are applied for the HSA Plus Plan, James will be responsible for $3,480. All rights reserved. To help your savings grow even more, when your HSA balance reaches $1,000, you can choose a variety of investments. Employees can now get a Health Care Plan Verification letter through Wolverine Access by selecting Employee Self-Service > Benefits > Health Care Plan Verification. 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 are new to an HMO, that HMO may ask you to select your primary care physician. [Instructor] Hello, and welcome to Blue Cross Blue Shield of Michigan. 0000021457 00000 n First, let's look at the cost to have a medical plan. Use the Find-a-Doctor tool to verify provider participation in one of our plan networks. Before you select a medical plan, consider your total costs, including the costs to have and use the plan. 0000048409 00000 n (tJ)Dpdd5* 7YG1}[X3C=Yvou*tdU`{NRGqZy3Cv{c.W+5gE|7?)z 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. *Blue Shield of California member plans only, Pre-service review for out-of-area members. 0000029999 00000 n 0000019432 00000 n Please provide the following information about the policy holder of the other health coverage. 0000051836 00000 n It has more than 20,000 physicians, including specialists, and more than 140 all acute care hospitals in Michigan. 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. 0000010545 00000 n Providers and facilities that fail to comply will be suppressed from our directories. 0000037572 00000 n To obtain a coordination of benefits letter, call the number on the back of your Enrollee ID card. 0000034448 00000 n We're sorry, but the attestation service is temporarily unavailable. 0000043394 00000 n 0000022731 00000 n Government Human Resources Benefits Health Benefit Plans. 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). 0000026320 00000 n 0000012476 00000 n This contribution will be prorated for employees who enroll mid-year. | _1S}9M{T=o9B^>.!a8Znpk9(6_ We appreciate your understanding. *Note: MSPTA-represented (T01) employees, DROP employees, and Other Eligible Adult Individuals (OEAIs) and their dependents are not eligible for this benefit. To request your QHC confirmation letter: Log in to your member account. Now let's look at some helpful scenarios that show how these plans work, considering the costs to have and use each plan. 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 $3,006 out of pocket to use this plan. *Except for those employees in certain bargaining units who are hired on or after 1/1/00 who have a regular work schedule of 40 hours or less per bi-weekly pay period (not permanent-intermittent positions). Give us a call to discuss your plan options. Representatives are available 8:00 a.m. to 5:00 p.m., Monday through Friday. After that deductible is met, out-of-network charges are paid according to the plan design. 0000048173 00000 n endstream endobj startxref 0000009570 00000 n General Inquiries. }v".VrTAmk$NJ+ y{i-Y#gds7D The deductible is the amount you pay before your plan contributes to your costs. 0000016284 00000 n Select Claims on the menu bar. 0000058981 00000 n startxref Physician Qualification Form (PDF) Healthy Blue Achieve Form Uses standard Blue Cross ID card. endstream endobj 14 0 obj <. We're making your EOB easier to understand. `+DO>|5%Nqdws=0y';L a66[OIe,%EqtRS&54Qvw"E$iu3:G+x+II^ UTT"9W!4XuYS6Ly}l&!2 0000048613 00000 n TVxZOEhL5wV/yZP^',UP1ko}87M@p_[8Sq^R/ You can keep your unlimited PIP coverage. Claims | Benefits | Member eligibility | How to use Provider Connection | Contracts | Credentialing | You don't need to wait until your new plan year starts to see your doctor. 0000030241 00000 n 93gpm},|P gaToY%+IzO96`%n'`Pll@BJa 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. Visit myfordbenefits.com and make your plan selection for 2023. When we look again at the total cost of having and using the plans, the HSA Plan is the lower cost option for John. 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. You still have the freedom to go out-of-network to see any physician, hospital or other provider of your choice. 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 Or, call the number on the back of your member ID card. 258 0 obj <> endobj Blue Cross Blue Shield of Michigan, in partnership with Lucet 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). K4[WYV5pL@=>QBuD State Health Plan PPO - Administered by Blue Cross Blue Shield of Michigan (BCBSM). Thank you for viewing. 0000018771 00000 n Let's say Mary and her family have a normal year with normal doctor visits. 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. startxref This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. 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 Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. 0000023020 00000 n The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. 0000016573 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 Behavior Health/Substance Use Disorder Administrator. <<674A7177E0417F4590EC384E93D00AED>]>> This provides cost and other information related to your plan options. Preventive care benefits are covered 100 percent when received from a TRUST PPO network provider. 577 0 obj <>stream %PDF-1.7 % 0000025874 00000 n 0000011869 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. Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. 0000023650 00000 n 0000024600 00000 n We can help. Thank you for viewing. 0000015623 00000 n Both plans include a health savings account HSA. 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. 140 0 obj <> endobj 0000017849 00000 n You can also opt-out if you qualify for that provision. 0000018397 00000 n Federal No Surprises Act: The federal government issued the "transparency in coverage" final rule under the Federal No Surprises Act. 800-229-2210 Available for commercial, Shared Advantage, and BlueCard. The HSA balance belongs to the employee and can be carried over from year to year. 0000011580 00000 n 0000008446 00000 n 0000025213 00000 n 0000007258 00000 n NO - YES - Please complete entire form, sign at the bottom and return sign at the bottom and return . 0000033229 00000 n They areresponsible for the deductible, then the hospital is reimbursed according to the plan design. 13 151 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 0000026848 00000 n Please see below for further information. 0000020798 00000 n 0000010017 00000 n State and Federal Privacy laws prohibit unauthorized access to Member's private information. You are encouraged to visit your benefit providers' website and create free member logins. 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 0000020133 00000 n And with the HSA Plus Plan, Ford will also contribute to your HSA. 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. 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 0000017479 00000 n 0 Please enable JavaScript in your browser for a better user experience. Callers to our phone lines are currently experiencing long wait times. Current SHP PPO enrollees will be automatically transitioned with no gap or changes in coverage. And he pay $2,280 annually to have the HSA Plus Plan. These scenarios are simple, and there are many other ways you can consider managing your out-of-pocket costs with your health savings account. 0000016814 00000 n Detroit, MI 48226-9942. 606 0 obj <>stream When you combine Mary's cost to have and use the HSA Plus Plan, her total cost is $5,306. 310 0 obj <>/Filter/FlateDecode/ID[<4C51D19B138643B1A2CB07133610D1D7>]/Index[258 116]/Info 257 0 R/Length 203/Prev 1461330/Root 259 0 R/Size 374/Type/XRef/W[1 3 1]>>stream Don't have a member account? For more info, visitwww.mi.gov/AutoInsurance, emailAutoInsurance@mi.gov, or call 833-ASK-DIFS (275-3437). Blue Cross Blue Shield of Michigan. Please refer to www.bcbsm.com/som for the list of providers. SM. 0000059656 00000 n 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. Be sure to turn off pop-up blocker and private browsing prior to opening your Auto Health verification letter. You can call the number on the back of your member ID card. 0000027006 00000 n (MSPTA-represented only) endstream Reviewplan materialscarefully to understand the advantages and risks associated with the plan. [Narrator] Hello again, and welcome to Blue Cross Blue Shield of Michigan. If you choose to do so, you will be responsible for both deductibles. But, if you receive services from a provider not in the PPO network, you may be responsible for paying additional out-of-pocket costs. Detroit, MI 48243. The document must: If you have additional BCBSM contracts, pleas e include this as other coverage. 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). 0000005625 00000 n endstream endobj startxref If you have any questions, call the phone number on the back of your Blue Cross ID card and we'll help. 0000007848 00000 n Submit and confirm authorizations and approval of medical and pharmacy services prior to services being rendered. 0000007421 00000 n This is the amount taken from your pay each month.
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