bcbsm qualified health coverage letter

0000059965 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. startxref lC]n8\! Michigans new auto no-fault insurance law went into effect July 1, 2020. em4MVRpH ~*.V%s^5h}R,uJXP;6s@bH{{J 4aWS8r *W~oKMwSV-Kl^voIb #TY^hAP38HUR{mv8azF`lAQm8yiKm77!}1nW {07 N_Bdk The plan covers inpatient hospital care, as well as other outpatient services received at a hospital including emergency room care. 0000006680 00000 n Go paperless by submitting claims and managing payments online for free. Other costs to use the HSA Plan will vary depending on whether you select plan coverage for you or for your family. 0000009279 00000 n You can now file disputes, attach supporting documents, and retrieve letters for submitted disputes online! The network covers all 83 Michigan counties and is the largest PPO network in Michigan. 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 93gpm},|P gaToY%+IzO96`%n'`Pll@BJa 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. This copay is waived if Mary or her family member is admitted as a result of the ER visit. 0000018771 00000 n 0000032777 00000 n 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. Log in to get your questions answered by a live representative, Monday through Friday, 6 a.m. to 6:30 p.m. 0000012476 00000 n 0000031798 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. Co-insurance is a percentage of the cost you share with the plan. 0000020133 00000 n Thank you for viewing. hm6?ZqJ!nv+E Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. 0000029999 00000 n 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. If you absolutely need to call, please try again at a later date. Mary would pay nothing from her paycheck to have the HSA 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. 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. SECTION 2 OTHER HEALTH COVERAGE INFORMATION . 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. Ford offers an accelerated contribution option. 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. "Qualified Health Coverage" means your health coverage: Does not exclude or limit coverage for motor vehicle accidents; and Has an annual deductible of $6,000.00 or less per covered individual. 140 0 obj <> endobj Depending the level of PIP you choose, your auto insurer may request a letter stating whether you have qualified health coverage, or QHC. 0000010919 00000 n 606 0 obj <>stream (MSPTA-represented only) After your deductible is met, co-insurance applies to medical and prescription costs until your out-of-pocket maximum is met. In the HSA Plus Plan, you're also responsible for all medical and prescription costs until your deductible is met. 0000010017 00000 n You can also take a closer look at your current plan to help you make the best choice for your 2021 plan. 0 Let's say Mary and her family have a normal year with normal doctor visits. Learn More Questions? Current SHP PPO enrollees will be automatically transitioned with no gap or changes in coverage. Blue Cross Blue Shield of Michigan: Understanding member ID cards IS IBCQ-]97T5dUa{ugdcg`\o'.Nu }n|7G|ZXXMf9I\RTt K{d\H3$]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. 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. This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. 0000005625 00000 n This amount does not count toward the plan's out-of-pocket maximum. Simply Blue. In our next scenario, James covers his wife on his medical plan. 0000016573 00000 n The Plan also covers most of your community-based care (office visits), as well as necessary medical equipment and supplies (crutches, hearing aids, etc.). 0000048834 00000 n 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. The maximum deductible for two or more covered persons in your family was limited to 1 months of your basic salary. <. 141 0 obj 0000048613 00000 n Thank you for viewing. 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 0000003914 00000 n 0000014041 00000 n You keep what you dont spend on medical expenses, even if you retire or leave state employment. Health Trust endstream endobj startxref 0000023650 00000 n 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. Now let's look at some helpful scenarios that show how these plans work, considering the costs to have and use each plan. }v".VrTAmk$NJ+ y{i-Y#gds7D The out-of-pocket maximum does not include monthly paycheck contributions, copayments, or any expenses not covered by your plan. 0000007421 00000 n For the HSA Plus Plan, Ford contributes $1,000 towards Mary's health savings account, which further reduces her cost to use this plan. 0000031112 00000 n 0000022070 00000 n 0000006389 00000 n 0rtq]%g=z.#i0\*m(D2q;t2}$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=. 0000019892 00000 n 0 0000048472 00000 n 0000005441 00000 n ^0} SX XD00{03pi`p. Your explanation of benefits (EOB) statement has a new look. SM. It has more than 20,000 physicians, including specialists, and more than 140 all acute care hospitals in Michigan. lo%x9d,oqM lzgw'TK6oB~+d; {qi.B/ R`]Hcq6~s_]=y&|9]Fl2b\o9Vp"(5Z9lb.dx;@? *Mii lkSW+0XI~'kT`C>?wlvR 0000048916 00000 n 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 BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. 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. endstream 0000026478 00000 n Please enable JavaScript in your browser for a better user experience. startxref Employees selecting the HSA Plan are responsible for a fixed amount copayment of $200 for each visit to the emergency room after your deductible has been met. %PDF-1.6 % As you can see, there are great benefits to having an HSA. 0000059887 00000 n 0000027783 00000 n %PDF-1.6 % 0000017188 00000 n <> PIP pays for services that health insurance may or may not cover. 0000048277 00000 n Once they've been met, the plan generally pays the full amount of your in-network medical and prescription costs. We provide health insurance in Michigan. hbbd``b`$WX@]@D0(, IH0@1% b Cu@\v d"3|` If you have additional BCBSM contracts, pleas e include this as other coverage. The network covers all 83 Michigan counties and is the largest PPO network in Michigan. h1aMXk* Q)DDJjH$*F 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). Behavior Health/Substance Use Disorder Administrator. 0000019062 00000 n Before you select a medical plan, consider your total costs, including the costs to have and use the plan. 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). Providers and facilities that fail to comply will be suppressed from our directories. 0000021457 00000 n 0000016814 00000 n 0000044573 00000 n There are different levels of PIP coverage that you can choose from. 0000005259 00000 n 0000025874 00000 n 0000021696 00000 n California Physicians Service DBA Blue Shield of California 1999-2023. View the Telemedicine Benefit Summary to see your State-sponsored health insurance carrier's telemedicine coverage. These plans also allow you to set aside tax-free funds that you can use for qualified medical expenses. Employees can also make pre-tax HSA contributions by payroll deductions. An HMO is a managed care plan that provides medical care through its network of physicians, pharmacies, contracted hospitals, and medical care suppliers. 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 $3,006 out of pocket to use this plan. 0000025213 00000 n 0000018397 00000 n Health insurance plans may contain auto exclusions (meaning they don't provide coverage for car accident-related injuries); may fail to cover the treatment, care and services needed by car accident victims; may limit such treatment, care and services in ways that No-Fault does not; and/or may involve managed care or HMOs which require *Blue Shield of California member plans only, Pre-service review for out-of-area members. 0000027161 00000 n 0000019721 00000 n Be sure to turn off pop-up blocker and private browsing prior to opening your Auto Health verification letter. You can call the number on the back of your member ID card. 0000060102 00000 n Access tools to prescreen, submit and check the status of submitted claims. Healthcare includes your Medical (ASR, BCBS, or HAP), Prescription (Navitus or HAP), Dental (Delta Dental), and Vision (NVA). <<674A7177E0417F4590EC384E93D00AED>]>> 0000027316 00000 n What's qualified health coverage under the new law? \8/$z Members enrolled in the HSA plan will be responsible for paying an ER copayment after the deductible has been met. .r~'J ms-oA&@i 9k2 J4T{Yt;cu6J_Fs"6r|(Z? The HSA balance belongs to the employee and can be carried over from year to year. We appreciate your understanding. *Blue Shield of California member plans only. Access commonly requested forms for patient care activities, credentialing, and more. hb``a`` -mY8PE!u[dCC#W6,j.Fvtl,s fb`p;CT3j PPO. Demographics |Electronic Data Interchange (EDI) | Recoveries, Need help with Provider Connection: Blue Shield Provider Connection Guide Provider Connection training. 0000021168 00000 n 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"). If you are new to an HMO, that HMO may ask you to select your primary care physician. Once logged in, navigate to the https://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/no-fault-changes.html 0000026660 00000 n 0000031415 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. TTY users should call 711. And with the HSA Plus Plan, Ford will also contribute to your HSA. PIP coverage can include items like attendant care, housing modifications and lost wages. *Note: MSPTA-represented (T01) employees, DROP employees, and Other Eligible Adult Individuals (OEAIs) and their dependents are not eligible for this benefit. When we look again at the total cost of having and using the plans, the HSA Plan is the lower cost option for John. Member logins offer many on-line tools, such as access to claims information, viewing Explanation of Benefits, printing replacement ID cards, etc. Available for commercial, Shared Advantage, and BlueCard. 0000008045 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. To help you compare and select your 2021 medical plan, Ford has provided Benefits Mentor powered by IBM Watson Health. 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. 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). 0000028187 00000 n With the HSA Plan, you pay 100% of medical and prescription costs until your deductible is met. 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. [Narrator] Hello again, and welcome to Blue Cross Blue Shield of Michigan. Claims | Benefits | Member eligibility | How to use Provider Connection | Contracts | Credentialing | 193 0 obj <>stream 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. bcbsm.com. i' *eW The HSA Plan is available to you at no cost. 0000020507 00000 n 0000006930 00000 n Questions About Your Benefits? Because Mary's cost to have the HSA Plan is $0, her total cost is $3,030. If the provider you select doesn't participate at all with BCBSM (BCBSM has several different provider arrangements), you may also be required to pay additional charges. Blue Cross Blue Shield of Michigan. Visit myfordbenefits.com and make your plan selection for 2023. Both plans include a health savings account HSA. 1200 N. Telegraph Road Qualified health coverage is health or accident insurance that doesn't exclude or limit coverage for injuries from auto accidents. %PDF-1.7 % We'll accept a qualification form from an office visit that occurred up to 180 days before the start of your plan year. Select Claims on the menu bar. hbbd```b``z"@$D2e5A$)e,H^0 An HDHP offers a lower biweekly premium in exchange for higher deductibles and out-of-pocket limits. Look for the chat icon at the bottom right corner of the screenon any page of this website. 248-524-0454 Learnyour requirements, deadline dates and more about your coverage. #G:&#WeKo]b287X]4 fd!n>X3jG[)GW%0.{1,JqA]Vf,fyf#Ji+OvDUpe!K|\"e2{g3ePW?/p 0000024600 00000 n State and Federal Privacy laws prohibit unauthorized access to Member's private 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. Field Service. 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. 0000034485 00000 n View the eGuide to see the Ford resources available all year long. 0000029225 00000 n You can keep your unlimited PIP coverage. Contact your auto insurance carrier for specific questions regarding PIP coverage. 0000042215 00000 n It has a deductible of $6,000 or less per person. 0000059434 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. 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. When asked to log in, choose Continue as a guest. Use the Find-a-Doctor tool to verify provider participation in one of our plan networks. %%EOF 0000024311 00000 n 0000006145 00000 n This plan didn't cover prescription charges, office visit charges, medical equipment, psychiatric services, or other major medical services. So when we consider the total cost to have and use the plans, the HSA Plus Plan is the less costly option. 1tv 0000026848 00000 n We're sorry, but the attestation service is temporarily unavailable. Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. He paid the full $800 cost of his medical services because the cost is less than the deductible for either plan. 0000049102 00000 n For Medicare Members: No-fault auto law changes Health (Just Now) WebThere are several ways you can request a QHC letter. 0000015914 00000 n 0000048409 00000 n New SHP PPO membership ID cards will be mailed in September 2019. After that deductible is met, out-of-network charges are paid according to the plan design. 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. The document must: xref Be informed about all your Blue Cross plan has to offer. Contact your auto insurance agent with questions and to learn more about your options. You are encouraged to visit your benefit providers' website and create free member logins. For the HSA Plan, your deductible and out-of-pocket maximum amounts for in-network services are the same. Let's start with Mary who selected a plan to cover her family. What does PIP cover? When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. endstream endobj 14 0 obj <. 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. 0000010545 00000 n To request your QHC confirmation letter: Log in to your member account. Create an account now. You can log in to your online member account to see if you have a QHC letter to download. 0000034422 00000 n General Inquiries. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

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