0000032777 00000 n 0000048540 00000 n This plan covered inpatient hospital expenses, as well as certain other services received at the hospital on an outpatient basis (including emergency room care). 163 0 obj <>stream For auto insurance policies issued or renewed after July 1, 2020, Michigan's Automobile No-Fault Insurance Law will change. Click continue to proceed with verification. startxref Available for commercial, Shared Advantage, and BlueCard. 0000033132 00000 n &yw}.$7eIw You still have the freedom to go out-of-network to see any physician, hospital or other provider of your choice. | _1S}9M{T=o9B^>.!a8Znpk9(6_ Two letters confirming you have MESSA coverage that are often requested by your auto insurance carrier can be found in your MyMESSA member account. 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. 0000008446 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. 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. 0000059211 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. (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 For all other claims, choose your health plan on this page to find the form and instructions for sending it in. 0000010017 00000 n 577 0 obj <>stream Learn More Questions? 0000024600 00000 n You have certain tasks to complete within specific . 0000048472 00000 n 0000010545 00000 n These scenarios are simple, and there are many other ways you can consider managing your out-of-pocket costs with your health savings account. SM. Utilize the Insurance Planspage to review plan summaries or contact the HMO that interests you to request their benefit booklet. GradCare Member Reimbursement Form U-M Premier Care Member Reimbursement Form Visit myfordbenefits.com and make your plan selection for 2023. Log in to continue with member verification. 0000051836 00000 n %%EOF 0000007848 00000 n This amount does not count toward the plan's out-of-pocket maximum. 0000027783 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). Give us a call to discuss your plan options. 0000014332 00000 n James has arthritis, so he needs to take a higher cost maintenance drug. 0000027316 00000 n 0000023276 00000 n endstream 0000048409 00000 n First, let's look at the cost to have a medical plan. Thank you for viewing. 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. 0000060102 00000 n 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. Health Plan Forms and Documents | Human Resources University of Michigan 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. %PDF-1.6 % PDF Sample Qualified Health Coverage Documentation - Michigan The HSA balance belongs to the employee and can be carried over from year to year. ^0} SX XD00{03pi`p. 0000027625 00000 n Blue Cross Blue Shield of Michigan. 0000021696 00000 n db4H@g& C endstream hb``a`` -mY8PE!u[dCC#W6,j.Fvtl,s fb`p;CT3j Thank you for viewing. Even though this law has to do with your auto insurance, a lot of people have questions about what it means for your. hb```5,|z cbD{600T|txGyG{T8"W3\baah4p1$$ v3Kx4@6@ 1 This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. To file a Blue Cross Blue Shield Global Core eClaim online, log in with your username and password or register for access. This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. With the HSA Plan, you pay 100% of medical and prescription costs until your deductible is met. Once logged in, navigate to the https://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/no-fault-changes.html %%EOF C.O.P.S. startxref 159 0 obj <>/Filter/FlateDecode/ID[<38505CF35D4D814CB849C61D42F0BD2C>]/Index[140 54]/Info 139 0 R/Length 99/Prev 142241/Root 141 0 R/Size 194/Type/XRef/W[1 3 1]>>stream 0000044573 00000 n 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. Coordination of Benefits Questionnaire - BCBSM PDF State of Michigan (MSPTA-represented only) 0000010306 00000 n 0000016573 00000 n Log in to get your questions answered by a live representative, Monday through Friday, 6 a.m. to 6:30 p.m. 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 endobj 14 0 obj <. Qualified Transportation Fringe Benefits (QTFB). If you absolutely need to call, please try again at a later date. 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. 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. 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. Employees can also make pre-tax HSA contributions by payroll deductions. 0000024311 00000 n And with the HSA Plus Plan, Ford will also contribute to your HSA. Respond promptly to the carrier to complete the final phase of the enrollment process. 0000008905 00000 n Your coverage is considered qualified if it: When making a decision, keep in mind that PIP has coverage that goes beyond traditional health insurance. 1tv Blue Care Network Qualification Form - BCBSM 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. If you choose to do so, you will be responsible for both deductibles. And he pay $2,280 annually to have the HSA Plus Plan. 0000035745 00000 n Where does my client go to get a Qualified Health Coverage (QHC) letter 0000048976 00000 n 0000017188 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. 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. This tool provides side-by-side medical plan comparisons and personalized cost modeling. To help you compare and select your 2021 medical plan, Ford has provided Benefits Mentor powered by IBM Watson Health. 0000037572 00000 n Claims | Benefits | Member eligibility | How to use Provider Connection | Contracts | Credentialing | 0000004052 00000 n What does PIP cover? hb``b``f`c`Taa@ V(-) Q>hL)[ley|800pt Pn`K Al@8m@@3J31k=21@=3 F%&hWfpdbm]` 0000048277 00000 n 0000030241 00000 n 0000004500 00000 n 0000033229 00000 n 0000004148 00000 n Per state and federal law, providers and facilities must attest to accuracy of directory information to stay visible in find a Doctor. 0000013137 00000 n PDF Blue Cross Blue Shield of Michigan: Understanding member ID cards Simply Blue. Please see below for further information. If you are new to an HMO, that HMO may ask you to select your primary care physician. 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. Members should direct specific questions about PIP coverage to their auto insurer. We're sorry, but the attestation service is temporarily unavailable. This means you have the option to increase your payroll contributions so you can reach the maximum contribution amount earlier in the year. Provider Connection Home | Blue Shield of CA Provider California Physicians Service DBA Blue Shield of California 1999-2023. Under the plan documents section, click Michigan Auto Reform to request a letter be mailed to the subscriber's address. No-fault auto insurance changes in Michigan | bcbsm.com Under the new legislation, residents may select different levels of PIP coverage. For the HSA Plus Plan, Ford contributes $1,000 towards Mary's health savings account, which further reduces her cost to use this plan. To request your QHC confirmation letter: Log in to your member account. For the HSA Plan, your deductible and out-of-pocket maximum amounts for in-network services are the same. You can also take a closer look at your current plan to help you make the best choice for your 2021 plan. 0000058981 00000 n Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health 0000012476 00000 n 0000014702 00000 n 0000026848 00000 n 0000007100 00000 n NO - YES - Please complete entire form, sign at the bottom and return sign at the bottom and return . 0000041020 00000 n You don't need to wait until your new plan year starts to see your doctor. State and Federal Privacy laws prohibit unauthorized access to Member's private information. See your 2023 Benefits-at-a-Glance (PDF) for more plan details. Your email address will not be published. What's qualified health coverage under the new law? 0000047030 00000 n You can keep your unlimited PIP coverage. 141 0 obj 0000059434 00000 n 0000048834 00000 n If you don't have a Provider Connection account, you will need to register before logging in. Federal No Surprises Act: The federal government issued the "transparency in coverage" final rule under the Federal No Surprises Act. Detroit, MI 48243. hbbd``b`$WX@]@D0(, IH0@1% b Cu@\v d"3|` 0000048683 00000 n 0000048755 00000 n 0000006389 00000 n 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). 0000038624 00000 n 0000020798 00000 n 0000009570 00000 n 0 %%EOF 0000019892 00000 n 0000029757 00000 n 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. $158 per month) Eligibility: All MSU students, Law students, Visiting scholars, and more, including spouse and children of a student enrolled in the plan. Michigans new auto no-fault insurance law went into effect July 1, 2020. For Medicare Members: No-fault auto law changes Health (Just Now) WebThere are several ways you can request a QHC letter. Need new coverage? To find the most up-to-date information about current medical and pharmacy claims, you can use the Blue Cross app or log into your BCBSM member account at bcbsm.com. If you're asked to provide your auto insurer with a QHC letter, you will either need to contact your health plan (like Blue Cross) or your employer to request the letter. <>stream }v".VrTAmk$NJ+ y{i-Y#gds7D Visit myfordbenefits.com and make your plan selection for 2023. 0000031415 00000 n Access commonly requested forms for patient care activities, credentialing, and more. 120 0 obj For Ford Employees: 2023 Health Plans | BCBSM Look for the chat icon at the bottom right corner of the screenon any page of this website. N'JV|DI]Ea:%*&[|{;z^HzwD/L_d?D/q|',W2tKpcukU;Bxc%w37XeNh{%_hl@zPMy * uAd;{i6pmn'D=6e Cvy"ngpdh6 s/8bG. 0000013667 00000 n You can use the money if you leave the company, change your plan, or retire. 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 $2,480. The web Browser you are currently using is unsupported, and some features of this site may not work as intended. 0 Simply . The deductible is the amount you pay before your plan contributes to your costs. Now let's look at what a single person with relatively few healthcare needs might experience. There are several ways you can request a QHC letter. 1-313-225-9000. You also have an out of pocket maximum, that's the maximum amount you pay in deductibles and applicable co-insurance during one plan year. Click My Plan and Spending. You may look up HMOs in your residential area using the zip code tool. But, if you receive services from a provider not in the PPO network, you may be responsible for paying additional out-of-pocket costs. hbbd```b``z"@$D2e5A$)e,H^0 For example: a single person chooses an in-network hospital for surgery. 0000048613 00000 n 0000025213 00000 n Find information about Promise Medi-Cal and Cal MediConnect, our policies, procedures and programs. 13 151 View detailed plan information in this document. 0000048916 00000 n 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. 0000015914 00000 n You are encouraged to visit your benefit providers' website and create free member logins. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. Your Benefit Guide State Health Plan PPO 3 Visit BCBSM Customer Service Center 232 S. Capitol Ave. Lansing, MI 48933 . Telemedicine Benefit Summary:Telemedicine visits allow you to meet with a US board-certified doctor online using a video-chat tool. 0000032096 00000 n 0000027006 00000 n The document must: 0000048207 00000 n 0000004937 00000 n PDF BCBSM Master Medical Claim Form %PDF-1.6 % TVxZOEhL5wV/yZP^',UP1ko}87M@p_[8Sq^R/ 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. 0000029515 00000 n 0000023941 00000 n For Medicare Members: No-fault auto law changes bcbsm.com Health (Just Now) WebThere are several ways you can request a QHC letter. Be informed about all your Blue Cross plan has to offer. 0000022731 00000 n Blue Shield/Blue Shield Promise network referrals. Depending the level of PIP you choose, your auto insurer may request a letter stating whether you have qualified health coverage, or QHC. 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? This plan didn't cover prescription charges, office visit charges, medical equipment, psychiatric services, or other major medical services. 0000043394 00000 n 0000019062 00000 n 0000025874 00000 n 0 Let's start with Mary who selected a plan to cover her family. 0000012767 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 0000009279 00000 n 0000013426 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 . View the eGuide to see the Ford resources available all year long. You can also review your current plan to help make the best choice for 2021. Blue Cross Blue Shield of Michigan, in partnership with Lucet Submit and confirm authorizations and approval of medical and pharmacy services prior to services being rendered. 0000006680 00000 n 0000014041 00000 n The out-of-pocket maximum does not include monthly paycheck contributions, copayments, or any expenses not covered by your plan. 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.
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