0000017479 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. 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. 0000028854 00000 n 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. endstream endobj 14 0 obj <. 0000020507 00000 n 0000030725 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. You're now aware you have a choice between two HSA eligible medical plans in 2021. 0000022070 00000 n 0000058981 00000 n Federal No Surprises Act: The federal government issued the "transparency in coverage" final rule under the Federal No Surprises Act. 0000007258 00000 n 0000013137 00000 n Under the new legislation, residents may select different levels of PIP coverage. Create an account now. 0000007628 00000 n %%EOF You can keep your unlimited PIP coverage. 0000027006 00000 n There are several ways you can request a QHC letter. 0000060102 00000 n You have certain tasks to complete within specific . In our next scenario, James covers his wife on his medical plan. 0000049165 00000 n We appreciate your understanding. 0000044573 00000 n 0000048207 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. 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. With the total of all her family services and prescriptions, the HSA Plan costs $3,030 to use. Your Benefit Guide State Health Plan PPO 3 Visit BCBSM Customer Service Center 232 S. Capitol Ave. Lansing, MI 48933 . 0000026660 00000 n Provided in a vehicle qualified as an ambulance and part of a licensed ambulance operation For example: a single person chooses an in-network hospital for surgery. 0000006680 00000 n endstream Once logged in, navigate to the https://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/no-fault-changes.html Qualified Transportation Fringe Benefits (QTFB). 0000026320 00000 n You can also take a closer look at your current plan to help you make the best choice for your 2021 plan. 0000059656 00000 n 0000007848 00000 n 0000023941 00000 n %%EOF 0000023020 00000 n 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. 93gpm},|P gaToY%+IzO96`%n'`Pll@BJa Learn More Questions? endstream 0000005259 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. 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 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. 0000048173 00000 n To obtain a coordination of benefits letter, call the number on the back of your Enrollee ID card. 0000034422 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). NO - YES - Please complete entire form, sign at the bottom and return sign at the bottom and return . 0000026478 00000 n The plan covers inpatient hospital care, as well as other outpatient services received at a hospital including emergency room care. 600 Lafayette East. 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 *Note: MSPTA-represented (T01) employees, DROP employees, and Other Eligible Adult Individuals (OEAIs) and their dependents are not eligible for this benefit. 0000007100 00000 n 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. 1200 N. Telegraph Road 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=. Contact your auto insurance agent with questions and to learn more about your options. 0000011869 00000 n Or, call the number on the back of your member ID card. hb``a`` -mY8PE!u[dCC#W6,j.Fvtl,s fb`p;CT3j %PDF-1.6 % 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. | _1S}9M{T=o9B^>.!a8Znpk9(6_ 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. 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. Please see below for further information. For Medicare Members: No-fault auto law changes Health (Just Now) WebThere are several ways you can request a QHC letter. Don't have a member account? 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 $3,006 out of pocket to use this plan. You can now file disputes, attach supporting documents, and retrieve letters for submitted disputes online! {07 N_Bdk 0000034485 00000 n State Health Plan PPO - Administered by Blue Cross Blue Shield of Michigan (BCBSM). Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. 0000036634 00000 n 0000031112 00000 n Please refer to www.bcbsm.com/som for the list of providers. 141 0 obj hbbd```b``z"@$D2e5A$)e,H^0 Later in the year, that same person needs an MRI and chooses an out-of-network provider. 0000009647 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. 0000042215 00000 n 0000035745 00000 n 'TMjZ}dM`V;hO0 45o` T@> $0,Tkpp9~#@="-toen7=u-J 3P6sO1v 0IA||$IRs3R6o'j*vU#;B!FL5O,hBtA7|$xVv)*09KTOM8Gh6CAIT,[*6a8 wz 0000027316 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. When we look again at the total cost of having and using the plans, the HSA Plan is the lower cost option for John. &yw}.$7eIw This contribution will be prorated for employees who enroll mid-year. Thank you for viewing. 0000048613 00000 n 0000048834 00000 n Look for the chat icon at the bottom right corner of the screenon any page of this website. Callers to our phone lines are currently experiencing long wait times. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. 0000031798 00000 n California Physicians Service DBA Blue Shield of California 1999-2023. <>stream 0000027473 00000 n `+DO>|5%Nqdws=0y';L a66[OIe,%EqtRS&54Qvw"E$iu3:G+x+II^ UTT"9W!4XuYS6Ly}l&!2 These plans also allow you to set aside tax-free funds that you can use for qualified medical expenses. 0000017849 00000 n 0000008446 00000 n 0000014041 00000 n 0000008905 00000 n 248-524-0454 [Narrator] Hello again, and welcome to Blue Cross Blue Shield of Michigan. 0000004052 00000 n Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. *Blue Shield of California member plans only. em4MVRpH ~*.V%s^5h}R,uJXP;6s@bH{{J 4aWS8r *W~oKMwSV-Kl^voIb #TY^hAP38HUR{mv8azF`lAQm8yiKm77!}1nW Because Mary's cost to have the HSA Plan is $0, her total cost is $3,030. Preventive care benefits are covered 100 percent when received from a TRUST PPO network provider. When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. Learn about our tools and how to use them in our upcoming webinars. 0000031415 00000 n $158 per month) Eligibility: All MSU students, Law students, Visiting scholars, and more, including spouse and children of a student enrolled in the plan. The Plan also covers most of your community-based care (office visits), as well as necessary medical equipment and supplies (crutches, hearing aids, etc.). We're making your EOB easier to understand. 0000018138 00000 n You are encouraged to visit your benefit providers' website and create free member logins. For more information about the State of Michigan's eligibility requirements for employee health insurance coverage, . To help your savings grow even more, when your HSA balance reaches $1,000, you can choose a variety of investments. lC]n8\! 163 0 obj <>stream 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). 0000029757 00000 n 0000016284 00000 n XYQ This product provides comprehensive PPO coverage with costsharing features. 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. ^0} SX XD00{03pi`p. Utilize the Insurance Planspage to review plan summaries or contact the HMO that interests you to request their benefit booklet. 0000014991 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. 0000009570 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 0000023650 00000 n 0000025874 00000 n This tool provides side-by-side medical plan comparisons and personalized cost modeling. Blue Cross Blue Shield of Michigan: Understanding member ID cards 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. No-fault auto insurance changes in Michigan bcbsm.com Health (6 days ago) WebThere are several ways you can request a QHC letter. You don't need to wait until your new plan year starts to see your doctor. Let's start with Mary who selected a plan to cover her family. 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. 0000021696 00000 n Submit and confirm authorizations and approval of medical and pharmacy services prior to services being rendered. See your 2023 Benefits-at-a-Glance (PDF) for more plan details. 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. 0000048540 00000 n 120 0 obj 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. This amount does not count toward the plan's out-of-pocket maximum. You still have the freedom to go out-of-network to see any physician, hospital or other provider of your choice. 0000005625 00000 n 0000029999 00000 n 0 TTY users should call 711. 0000005441 00000 n a health reimbursement arrangement which helps members pay for qualified medical expenses. Government Human Resources Benefits Health Benefit Plans. h1aMXk* Q)DDJjH$*F The web Browser you are currently using is unsupported, and some features of this site may not work as intended. 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. View detailed plan information in this document. \8/$z Co-insurance is a percentage of the cost you share with the plan. 0000000016 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. They are responsible for the out-of-network deductible. 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. Click continue to proceed with verification. And he pay $2,280 annually to have the HSA Plus Plan. For more info, visitwww.mi.gov/AutoInsurance, [email protected], or call 833-ASK-DIFS (275-3437). 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. %PDF-1.6 % 0000048409 00000 n For all other claims, choose your health plan on this page to find the form and instructions for sending it in. 0000041020 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. After that deductible is met, out-of-network charges are paid according to the plan design. 0000059965 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 help you compare and select your 2021 medical plan, Ford has provided Benefits Mentor powered by IBM Watson Health. 0000022361 00000 n An HDHP offers a lower biweekly premium in exchange for higher deductibles and out-of-pocket limits. Mary would pay nothing from her paycheck to have the HSA Plan. For the HSA Plus Plan, her yearly contributions, which is her cost to have the plan would be $3,300. As you can see, there are great benefits to having an HSA. This tool provides side-by-side medical plan comparisons and personalized cost modeling. 0000048277 00000 n Both plans include a health savings account HSA. This is the amount taken from your pay each month. PPO. Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader, Important Information About MedicarePlans. Reviewplan materialscarefully to understand the advantages and risks associated with the plan. <. Field Service. Other costs to use the HSA Plan will vary depending on whether you select plan coverage for you or for your family. 13 151 Log in to get your questions answered by a live representative, Monday through Friday, 6 a.m. to 6:30 p.m. Now let's look at some helpful scenarios that show how these plans work, considering the costs to have and use each plan. 0000019062 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. 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. James has arthritis, so he needs to take a higher cost maintenance drug. Learn more about your Blue Cross Blue Shield of Michigan plan options. We'll accept a qualification form from an office visit that occurred up to 180 days before the start of your plan year. What's qualified health coverage under the new law? Physician Qualification Form (PDF) Healthy Blue Achieve Form New SHP PPO membership ID cards will be mailed in September 2019. Claims | Benefits | Member eligibility | How to use Provider Connection | Contracts | Credentialing | endobj 0000003382 00000 n "Qualified Health Coverage" means your health coverage: Does not exclude or limit coverage for motor vehicle accidents; and Has an annual deductible of $6,000.00 or less per covered individual. If you have additional BCBSM contracts, pleas e include this as other coverage. 0000025504 00000 n <<674A7177E0417F4590EC384E93D00AED>]>> 0000028562 00000 n It has more than 20,000 physicians, including specialists, and more than 140 all acute care hospitals in Michigan. 193 0 obj <>stream This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. When an out-of-area Blue plan member seeks medical care from your office, use our tools to simplify claims submission to BlueShield of California. If your auto insurance is requesting a QHC letter to issue or renew a policy, you may request a QHC letter by contacting your health carrier. hbbd``b`$WX@]@D0(, IH0@1% b Cu@\v d"3|` 0 0 It has more than 20,000 physicians, including specialists, and more than 140 all acute care hospitals in Michigan. An HMO provides necessary hospital and medical treatment when you are sick or injured, prescription medicine services, substance abuse treatment, short-term mental health care, and routine preventive health maintenance services such as immunizations. 1-313-225-9000. Log in to continue with member verification. Visit myfordbenefits.com and make your plan selection for 2023. Simply Blue. You can use the money if you leave the company, change your plan, or retire. 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. <> 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.
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