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Under the new legislation, residents may select different levels of PIP coverage. lC]n8\! Blue Cross Blue Shield of Michigan. Reviewplan materialscarefully to understand the advantages and risks associated with the plan. Earnings on an HSA fund balance are tax-free, and you can withdraw your money tax-free anytime, as long as you use it for qualified medical expenses for yourself or your tax dependents. 0000048540 00000 n
Uses standard Blue Cross ID card. Take a look at what Blue Cross plans offer, then choose the one that's right for you. 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). 0000010545 00000 n
Both plans include a health savings account HSA. Identified standard preventive services are covered at 100%, but most other services have a 20% in-network coinsurance after meeting the deductible. This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law.
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. 0000034448 00000 n
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(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 This tool provides side-by-side medical plan comparisons and personalized cost modeling. The network covers all 83 Michigan counties and is the largest PPO network in Michigan. To help you compare and select your 2021 medical plan, Ford has provided Benefits Mentor powered by IBM Watson Health. Blue Shield/Blue Shield Promise network referrals.
Michigan Auto Insurance Reform -- What HAP Members Should Know 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. This tool provides side-by-side medical plan comparisons and personalized cost modeling. Provided in a vehicle qualified as an ambulance and part of a licensed ambulance operation Or, call the number on the back of your member ID card.
Let's say Mary and her family have a normal year with normal doctor visits. 606 0 obj
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Visit Federal No Surprises Act (michigan.gov)for more information. 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. The web Browser you are currently using is unsupported, and some features of this site may not work as intended. These scenarios are simple, and there are many other ways you can consider managing your out-of-pocket costs with your health savings account. 0000031415 00000 n
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This plan didn't cover prescription charges, office visit charges, medical equipment, psychiatric services, or other major medical services. 0000012102 00000 n
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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. An important note regarding the State Health Plan PPO deductibles: You have the freedom to see both in-network and out-of-network providers. But, if you receive services from a provider not in the PPO network, you may be responsible for paying additional out-of-pocket costs. The HSA Plan is available to you at no cost. 1tv 0000005625 00000 n
After that deductible is met, out-of-network charges are paid according to the plan design. After your deductible is met, co-insurance applies to medical and prescription costs until your out-of-pocket maximum is met.
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. This plan covered inpatient hospital expenses, as well as certain other services received at the hospital on an outpatient basis (including emergency room care). endstream
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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. 0000014702 00000 n
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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 b|=b}#Aif3TRD0;@NHkQ#`VEQxD Callers to our phone lines are currently experiencing long wait times.
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 Your co-insurance amount for in-network services is 20%.
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[Instructor] Hello, and welcome to Blue Cross Blue Shield of Michigan. Thank you for viewing. endstream 0000026478 00000 n
Your doctor will submit the form by following the instructions on the back. When we look again at the total cost of having and using the plans, the HSA Plan is the lower cost option for John. This contribution will be prorated for employees who enroll mid-year. Access tools to prescreen, submit and check the status of submitted claims.
PDF Blue Cross Blue Shield of Michigan: Understanding member ID cards The account and money are yours. As you can see, there are great benefits to having an HSA. 13 151
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Simply Blue. Demographics |Electronic Data Interchange (EDI) | Recoveries, Need help with Provider Connection: Blue Shield Provider Connection Guide Provider Connection training. Your coverage is considered qualified if it: When making a decision, keep in mind that PIP has coverage that goes beyond traditional health insurance. He paid the full $800 cost of his medical services because the cost is less than the deductible for either plan. 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"). endstream
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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
Michigan - Blue Cross and Blue Shield's Federal Employee Program They won't charge you the difference between their normal charge and the amount paid by the State Health Plan PPO. Other costs to use the HSA Plan will vary depending on whether you select plan coverage for you or for your family. 0000039800 00000 n
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.r~'J ms-oA&@i 9k2 J4T{Yt;cu6J_Fs"6r|(Z? For example: a single person chooses an in-network hospital for surgery. Field Service. 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. 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. Depending the level of PIP you choose, your auto insurer may request a letter stating whether you have qualified health coverage, or QHC. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. i'
*eW This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law.
Blue Care Network Qualification Form - BCBSM <<674A7177E0417F4590EC384E93D00AED>]>>
Under the plan documents section, click Michigan Auto Reform to request a letter be mailed to the subscriber's address. 0000031112 00000 n
Go paperless by submitting claims and managing payments online for free. Please refer to www.bcbsm.com/som for the list of providers. 0000031798 00000 n
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1200 N. Telegraph Road
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Coordination of Benefits Questionnaire - BCBSM 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 $2,480. startxref h1aMXk* Q)DDJjH$*F 0000047030 00000 n
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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. 0000022070 00000 n
Plan: Blue Care Network (BCN) Premium Cost: Summer 5/16/20 - 8/15/20 $474.00 (approx. You can use the money if you leave the company, change your plan, or retire. 0000048755 00000 n
Learnyour requirements, deadline dates and more about your coverage. 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. Try again later. 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). NO - YES - Please complete entire form, sign at the bottom and return sign at the bottom and return . Blue Cross Blue Shield of Michigan: Understanding member ID cards 258 0 obj
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The out-of-pocket maximum does not include monthly paycheck contributions, copayments, or any expenses not covered by your plan. Once they've been met, the plan generally pays the full amount of your in-network medical and prescription costs. 0000006930 00000 n
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Telemedicine Benefit Summary:Telemedicine visits allow you to meet with a US board-certified doctor online using a video-chat tool. There are several ways you can request a QHC letter. Claims | Benefits | Member eligibility | How to use Provider Connection | Contracts | Credentialing | The HSA balance belongs to the employee and can be carried over from year to year. 0000012476 00000 n
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Questions About Your Benefits? 0000006680 00000 n
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Your Benefit Guide State Health Plan PPO 3 Visit BCBSM Customer Service Center 232 S. Capitol Ave. Lansing, MI 48933 . Access commonly requested forms for patient care activities, credentialing, and more. 0000017479 00000 n
Health Insurance Coverage | Health Services | Michigan State University Effective January 1, 2023, MSPTA-represented (To1) employees are eligible for this benefit, DROP employees and OEAIs and the dependents remain ineligible. James has arthritis, so he needs to take a higher cost maintenance drug. 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.
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When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. {07
N_Bdk Links to all provider websites can be found on our Benefit Carrier Contact Information page. 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. If you choose to do so, you will be responsible for both deductibles. 0000016814 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. And that both plans include a health savings account or HSA, that allows you to set aside tax-free funds that you can use for qualified medical expenses. 0000029757 00000 n
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Your email address will not be published. Qualified health coverage is health or accident insurance that doesn't exclude or limit coverage for injuries from auto accidents. Respond promptly to the carrier to complete the final phase of the enrollment process. You can now file disputes, attach supporting documents, and retrieve letters for submitted disputes online! With the total of all her family services and prescriptions, the HSA Plan costs $3,030 to use. To request your QHC confirmation letter: Log in to your member account. You have certain tasks to complete within specific . Health Insurance Marketplace Check out information about the Marketplace, especially if you are not eligible for coverage through LCC. If the provider you select doesn't participate at all with BCBSM (BCBSM has several different provider arrangements), you may also be required to pay additional charges. 0000026848 00000 n
Log in now myfordbenefits.com HELPS YOU: View personalized benefits For the HSA Plan, your deductible and out-of-pocket maximum amounts for in-network services are the same. When an out-of-area Blue plan member seeks medical care from your office, use our tools to simplify claims submission to Blue Shield of California. You can keep your unlimited PIP coverage. You must be in pay status to receive this payment.
Health Plan Details %%EOF *Note: MSPTA-represented (T01) employees, DROP employees, and Other Eligible Adult Individuals (OEAIs) and their dependents are not eligible for this benefit. It has more than 20,000 physicians, including specialists, and more than 140 all acute care hospitals in Michigan. 193 0 obj
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This amount does not count toward the plan's out-of-pocket maximum. John's annual paycheck deduction for the HSA Plan is zero. Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader, Important Information About MedicarePlans. You can also take a closer look at your current plan to help you make the best choice for your 2021 plan. Now let's look at what a single person with relatively few healthcare needs might experience. This means you have the option to increase your payroll contributions so you can reach the maximum contribution amount earlier in the year. 0rtq]%g=z.#i0\*m(D2q;t2}$kX[-+G-0hdA9r*8!jcsfEdRyV0=bLzf']q[6F"h.wB)^wvDH
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hb``b``f`c`Taa@ V(-) Q>hL)[ley|800pt Pn`K Al@8m@@3J31k=21@=3 F%&hWfpdbm]` 600 Lafayette East. %%EOF
PDF Best of Health Medicare What to Know About Changes to Michigan's Car Insurance Law 0000058981 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. 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. 0000007100 00000 n
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In the HSA Plus Plan, you're also responsible for all medical and prescription costs until your deductible is met. 0000007421 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. 0000025213 00000 n
Once logged in, navigate to the QHC letter in the Proof of Insurance section at the bottom of the page. Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health 0000026320 00000 n
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California Physicians Service DBA Blue Shield of California 1999-2023. The network covers all 83 Michigan counties and is the largest PPO network in Michigan. 0000051836 00000 n
You can log in to your online member account to see if you have a QHC letter to download.
%%EOF
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View detailed plan information in this document. Blue Cross Blue Shield of Michigan, in partnership with Lucet 0000022731 00000 n
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. Employees can also make pre-tax HSA contributions by payroll deductions.
Where does my client go to get a Qualified Health Coverage (QHC) letter Look for the chat icon at the bottom right corner of the screenon any page of this website. 0
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See below.
PDF Hospital Coverage Letter - Bcbstx Qualified Transportation Fringe Benefits (QTFB). PPO. %PDF-1.7
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When you combine Mary's cost to have and use the HSA Plus Plan, her total cost is $5,306. James wouldn't have to pay anything from his paycheck to have the HSA Plan. The maximum deductible for two or more covered persons in your family was limited to 1 months of your basic salary.
Qualified Healthcare Coverage Letter hm6?ZqJ!nv+E 0000015249 00000 n
Thank you for viewing. Providers and facilities that fail to comply will be suppressed from our directories. For the best experience, use the latest version of Google Chrome or Microsoft Edge. %PDF-1.6
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In our next scenario, James covers his wife on his medical plan. 0000033229 00000 n
Government Human Resources Benefits Health Benefit Plans. hb```5,|z cbD{600T|txGyG{T8"W3\baah4p1$$ v3Kx4@6@ 1
The plan covers inpatient hospital care, as well as other outpatient services received at a hospital including emergency room care. 0000016573 00000 n
Because Mary's cost to have the HSA Plan is $0, her total cost is $3,030. 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.
PDF Sample Qualified Health Coverage Documentation - Michigan Later in the year, that same person needs an MRI and chooses an out-of-network provider. 0000048277 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. No-fault auto insurance changes in Michigan bcbsm.com Health (6 days ago) WebThere are several ways you can request a QHC letter. 0000016284 00000 n
The State Health Plan PPO provides reimbursement for medical care expenses when you need treatment for an illness, injury, or disease. 141 0 obj
After the deductible and coinsurance are applied for the HSA Plus Plan, James will be responsible for $3,480. 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. TVxZOEhL5wV/yZP^',UP1ko}87M@p_[8Sq^R/ They are responsible for the out-of-network deductible. db4H@g& C 0000019062 00000 n
Difs Qualified Health Care Letter Health Benefit Plans | Oakland County, MI Click continue to proceed with verification. 0000004148 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. Visit myfordbenefits.com and make your plan selection for 2023. In 2021, you'll have a choice between two HSA eligible medical plans, HSA Plan and HSA Plus Plan.
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Here's how these plans work. endobj
Michigan Auto Insurance & Coordination of Benefits Explained Preventive care benefits are covered 100 percent when received from a TRUST PPO network provider. Pontiac, MI 48341. &yw}.$7eIw
PDF State of Michigan %PDF-1.7
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Be sure to turn off pop-up blocker and private browsing prior to opening your Auto Health verification letter. 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. 0000048349 00000 n
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startxref
Two letters confirming you have MESSA coverage that are often requested by your auto insurance carrier can be found in your MyMESSA member account. 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. Your explanation of benefits (EOB) statement has a new look. Click My Plan and Spending. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. 119 0 obj 0000048613 00000 n
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BlueCard Program home page. Ready to enroll? 0000000016 00000 n
For more info, visitwww.mi.gov/AutoInsurance, emailAutoInsurance@mi.gov, or call 833-ASK-DIFS (275-3437). 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 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. 0000060222 00000 n
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Visit myfordbenefits.com and make your plan selection for 2023. To request a proof of qualified health coverage letter, contact Blue Cross' Customer Service department at 1-800-422-9146from 8:30 a.m. to 5 p.m. Eastern time, Monday through Friday. 0000034422 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. Learn more about your Blue Cross Blue Shield of Michigan plan options. xref
C.O.P.S. 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.
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