bcbsm qualified health coverage letter

0000006145 00000 n startxref 0000019892 00000 n 0000031798 00000 n 0000010545 00000 n Behavior Health/Substance Use Disorder Administrator. Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader, Important Information About MedicarePlans. For the HSA Plus Plan, Ford contributes $1,000 towards Mary's health savings account, which further reduces her cost to use this plan. 0000009279 00000 n 0000048540 00000 n Need a Health Care Plan Verification Letter for Your Auto Insurance 0000060222 00000 n What does PIP cover? 0000048409 00000 n Health Benefit Plans | Oakland County, MI %PDF-1.6 % 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). Once logged in, navigate to the https://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/no-fault-changes.html 0 Your coverage is considered qualified if it: When making a decision, keep in mind that PIP has coverage that goes beyond traditional health insurance. What to Know About Changes to Michigan's Car Insurance Law Mail Code 1112. This is the amount taken from your pay each month. Click My Plan and Spending. For all other claims, choose your health plan on this page to find the form and instructions for sending it in. This means you have the option to increase your payroll contributions so you can reach the maximum contribution amount earlier in the year. Learnyour requirements, deadline dates and more about your coverage. Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. These scenarios are simple, and there are many other ways you can consider managing your out-of-pocket costs with your health savings account. This tool provides side-by-side medical plan comparisons and personalized cost modeling. 0000030725 00000 n So when we consider the total cost to have and use the plans, the HSA Plus Plan is the less costly option. Learn more about your Blue Cross Blue Shield of Michigan plan options. 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. 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 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. 0000034485 00000 n Other costs to use the HSA Plan will vary depending on whether you select plan coverage for you or for your family. 0000034422 00000 n 14. other health care coverage 16. other policy holder's last name 19. other policy holder's date of birth 17. other policy holder's first name 20. name of other health carrier 21. other carrier policy/group number 22. other carrier street address city state zip code 23. other employer name major medical 24. type of other health insurance . Thank you for viewing. *Blue Shield of California member plans only, Pre-service review for out-of-area members. This tool provides side-by-side medical plan comparisons and personalized cost modeling. After your deductible is met, co-insurance applies to medical and prescription costs until your out-of-pocket maximum is met. Plan: Blue Care Network (BCN) Premium Cost: Summer 5/16/20 - 8/15/20 $474.00 (approx. An HMO is a managed care plan that provides medical care through its network of physicians, pharmacies, contracted hospitals, and medical care suppliers. 0000059434 00000 n Telemedicine Benefit Summary:Telemedicine visits allow you to meet with a US board-certified doctor online using a video-chat tool. 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. 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. Simply Blue. John's annual paycheck deduction for the HSA Plan is zero. 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. 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. Use the Find-a-Doctor tool to verify provider participation in one of our plan networks. In 2021, you'll have a choice between two HSA eligible medical plans, HSA Plan and HSA Plus Plan. 373 0 obj <>stream 0000004937 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. "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. For Medicare Members: No-fault auto law changes Health (Just Now) WebThere are several ways you can request a QHC letter. db4H@g& C Medical Insurance - Lansing Community College This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. PDF Best of Health Medicare Before you select a medical plan, consider your total costs, including the costs to have and use the plan. Preventive care benefits are covered 100 percent when received from a TRUST PPO network provider. 0000010017 00000 n 0000033132 00000 n b|=b}#Aif3TRD0;@NHkQ#`VEQxD 0000041020 00000 n Blue Care Network Qualification Form - BCBSM Learn More Questions? No-fault auto insurance changes in Michigan bcbsm.com Health (6 days ago) WebThere are several ways you can request a QHC letter. 0000028562 00000 n 0000014702 00000 n 0000005858 00000 n The document must: Physician Qualification Form (PDF) Healthy Blue Achieve Form 0000020507 00000 n 0000022361 00000 n Your doctor will submit the form by following the instructions on the back. You can call the number on the back of your member ID card. These plans also allow you to set aside tax-free funds that you can use for qualified medical expenses. 0000012767 00000 n 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. 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. 0000011580 00000 n This contribution will be prorated for employees who enroll mid-year. The plan covers inpatient hospital care, as well as other outpatient services received at a hospital including emergency room care. Difs Qualified Health Care Letter 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 We can help. endstream endobj startxref 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. Uses standard Blue Cross ID card. 193 0 obj <>stream 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. 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). trailer 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. Claims | Benefits | Member eligibility | How to use Provider Connection | Contracts | Credentialing | The Plan also covers most of your community-based care (office visits), as well as necessary medical equipment and supplies (crutches, hearing aids, etc.). Employees can also make pre-tax HSA contributions by payroll deductions. 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. 0000032373 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. 13 151 0000048916 00000 n Where does my client go to get a Qualified Health Coverage (QHC) letter 0000048613 00000 n Ford offers an accelerated contribution option. SECTION 2 OTHER HEALTH COVERAGE INFORMATION . TTY users should call 711. Qualified Health Coverage & Michigan No-Fault Insurance 1200 N. Telegraph Road 0000007258 00000 n PDF Blue Cross Blue Shield of Michigan: Understanding member ID cards James wouldn't have to pay anything from his paycheck to have the HSA Plan. You're now aware you have a choice between two HSA eligible medical plans in 2021. After the deductible and coinsurance are applied for the HSA Plus Plan, James will be responsible for $3,480. 0000006680 00000 n State Health Plan Preferred Provider Organization (PPO) The out-of-pocket maximum does not include monthly paycheck contributions, copayments, or any expenses not covered by your plan. Thank you for viewing. 0000015249 00000 n You still have the freedom to go out-of-network to see any physician, hospital or other provider of your choice. 0000030241 00000 n 0 Benefits under this plan were payable only after you had paid expenses equal to one month's basic salary (your deductible). But, if you receive services from a provider not in the PPO network, you may be responsible for paying additional out-of-pocket costs. You have certain tasks to complete within specific . 0000022731 00000 n GradCare Member Reimbursement Form U-M Premier Care Member Reimbursement Form 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 hb``a`` -mY8PE!u[dCC#W6,j.Fvtl,s fb`p;CT3j 0000016814 00000 n For more info, visitwww.mi.gov/AutoInsurance, emailAutoInsurance@mi.gov, or call 833-ASK-DIFS (275-3437). 0000005441 00000 n PIP pays for services that health insurance may or may not cover. 0000008243 00000 n Blue Cross Blue Shield of Michigan. The network covers all 83 Michigan counties and is the largest PPO network in Michigan. Qualified health coverage is health or accident insurance that doesn't exclude or limit coverage for injuries from auto accidents. HSA Plan and HSA Plus Plan. Submit and confirm authorizations and approval of medical and pharmacy services prior to services being rendered. 0000032096 00000 n endstream endobj 14 0 obj <. Be informed about all your Blue Cross plan has to offer. Blue Cross Blue Shield of Michigan: Understanding member ID cards $"mY_%Be66y=\"QI This plan covered inpatient hospital expenses, as well as certain other services received at the hospital on an outpatient basis (including emergency room care). 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. Bcbsm Qualified Health Coverage Letter 0000048976 00000 n C.O.P.S. If you absolutely need to call, please try again at a later date. You can now file disputes, attach supporting documents, and retrieve letters for submitted disputes online! Visit, Go to Qualified Transportation Fringe Benefits (QTFB), Active Employee State Health Plan PPO BCBSM Plan Booklet, Retiree State Health Plan PPO With Medicare Booklet, Understanding HMO Insurance Premium Rates. You may enroll in an authorized HMO plan serving your residential area. We provide health insurance in Michigan. To get reimbursed for a flu or pneumonia shot, you'll need to fill out our Member Flu and Pneumonia Shots Reimbursement Form (PDF). 0000026478 00000 n PDF Hospital Coverage Letter - Bcbstx Create an account now. Health Insurance Coverage | Health Services | Michigan State University 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. When asked to log in, choose Continue as a guest. *Blue Shield of California member plans only. 0000051836 00000 n 0000018138 00000 n To file a Blue Cross Blue Shield Global Core eClaim online, log in with your username and password or register for access. 0000020798 00000 n Your explanation of benefits (EOB) statement has a new look. An HSA is a smart way to save for your future qualified health expenses, including those that may come up in retirement. *Note: MSPTA-represented (T01) employees, DROP employees, and Other Eligible Adult Individuals (OEAIs) and their dependents are not eligible for this benefit. 0000024839 00000 n 0000009570 00000 n lo%x9d,oqM lzgw'TK6oB~+d; {qi.B/ R`]Hcq6~s_]=y&|9]Fl2b\o9Vp"(5Z9lb.dx;@? *Mii lkSW+0XI~'kT`C>?wlvR 0000029999 00000 n 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. General Inquiries. Blue Shield/Blue Shield Promise network referrals. Take a look at what Blue Cross plans offer, then choose the one that's right for you. 0000021457 00000 n 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. 0000019062 00000 n [Instructor] Hello, and welcome to Blue Cross Blue Shield of Michigan. 0000023276 00000 n 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. 0000017479 00000 n 93gpm},|P gaToY%+IzO96`%n'`Pll@BJa We're redirecting you to Blue Shield of California's Find a doctor search. 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. 0000043394 00000 n 248-524-0454 0000025874 00000 n endobj For Medicare Members: No-fault auto law changes bcbsm.com Health (Just Now) WebThere are several ways you can request a QHC letter. 1tv 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. They are responsible for the out-of-network deductible. 0000017849 00000 n [Narrator] Hello again, and welcome to Blue Cross Blue Shield of Michigan. 0000037572 00000 n Try again later. 0000027161 00000 n You keep what you dont spend on medical expenses, even if you retire or leave state employment. An HDHP offers a lower biweekly premium in exchange for higher deductibles and out-of-pocket limits. 0000005259 00000 n endstream endobj startxref Health Plan Forms and Documents | Human Resources University of Michigan The web Browser you are currently using is unsupported, and some features of this site may not work as intended. 0000036168 00000 n This provides cost and other information related to your plan options. You are encouraged to visit your benefit providers' website and create free member logins. An important note regarding the State Health Plan PPO deductibles: You have the freedom to see both in-network and out-of-network providers. 0000014991 00000 n State Health Plan PPO - Administered by Blue Cross Blue Shield of Michigan (BCBSM). Please enable JavaScript in your browser for a better user experience. 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. endobj .r~'J ms-oA&@i 9k2 J4T{Yt;cu6J_Fs"6r|(Z? 577 0 obj <>stream 258 0 obj <> endobj He paid the full $800 cost of his medical services because the cost is less than the deductible for either plan. Mary would pay nothing from her paycheck to have the HSA Plan. 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. The HSA Plan is available to you at no cost. 0000024311 00000 n 0000027006 00000 n 0000033229 00000 n And for the HSA Plus Plan, it's $1,020. Both plans include a health savings account HSA. <. | _1S}9M{T=o9B^>.!a8Znpk9(6_ We'll accept a qualification form from an office visit that occurred up to 180 days before the start of your plan year. Blue Cross Blue Shield of Michigan, in partnership with Lucet 0000006389 00000 n 159 0 obj <>/Filter/FlateDecode/ID[<38505CF35D4D814CB849C61D42F0BD2C>]/Index[140 54]/Info 139 0 R/Length 99/Prev 142241/Root 141 0 R/Size 194/Type/XRef/W[1 3 1]>>stream Fax: 248-524-2752, https://dev.michigan.local/som/json?sc_device=json, State Health Plan Preferred Provider Organization (PPO), State High Deductible Health Plan (HDHP) with Health Savings Account (HSA), Catastrophic Benefits (Effective January 1, 2023 this plan is no longer available to employees and their dependents), OptumRx is the Pharmacy Benefit Manager for the State Health Plan PPOand will administer all retail, mail-order, and specialty, State High Deductible HealthPlan (HDHP) with, dministered by Blue Cross Blue Shield of Michigan (BCBSM),HSA a, The federal government issued the "transparency in coverage" final rule under the Federal No Surprises Act. Let's start with Mary who selected a plan to cover her family. hbbd```b``z"@$D2e5A$)e,H^0 Government Human Resources Benefits Health Benefit Plans. <>stream Michigans new auto no-fault insurance law went into effect July 1, 2020. PDF Blue Cross Blue Shield of Michigan: Understanding member ID cards 0000012476 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). (tJ)Dpdd5* 7YG1}[X3C=Yvou*tdU`{NRGqZy3Cv{c.W+5gE|7?)z 0000009647 00000 n 0000049165 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 0000008674 00000 n It has a deductible of $6,000 or less per person. 163 0 obj <>stream Members should direct specific questions about PIP coverage to their auto insurer. N'JV|DI]Ea:%*&[|{;z^HzwD/L_d?D/q|',W2tKpcukU;Bxc%w37XeNh{%_hl@zPMy * uAd;{i6pmn'D=6e Cvy"ngpdh6 s/8bG. 0000028854 00000 n 119 0 obj Providers and facilities that fail to comply will be suppressed from our directories. %PDF-1.7 % We're making your EOB easier to understand. Contact your auto insurance agent with questions and to learn more about your options. 0000014332 00000 n Access tools to prescreen, submit and check the status of submitted claims. You can choose your own primary care physician who will provide direct care or make referrals from within the network. Under the plan documents section, click Michigan Auto Reform to request a letter be mailed to the subscriber's address. To obtain a coordination of benefits letter, call the number on the back of your Enrollee ID card. Let's say Mary and her family have a normal year with normal doctor visits. TVxZOEhL5wV/yZP^',UP1ko}87M@p_[8Sq^R/ Employees selecting the HSA Plan are responsible for a fixed amount copayment of $200 for each visit to the emergency room after your deductible has been met. Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health Automobile No-Fault Insurance Changes: Prior to July 2, 2020, Michigans Automobile No-Fault Insurance Law required individuals to purchase unlimited Personal Injury Protection (PIP) through their auto insurer. Now let's look at what a single person with relatively few healthcare needs might experience. See below. \8/$z The deductible is the amount you pay before your plan contributes to your costs. 0000013137 00000 n PDF BCBSM Master Medical Claim Form 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. 0000023020 00000 n }v".VrTAmk$NJ+ y{i-Y#gds7D If you don't have a Provider Connection account, you will need to register before logging in. Individuals attempting unauthorized access will be prosecuted. Questions About Your Benefits? 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. 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. 0000017188 00000 n And he pay $2,280 annually to have the HSA Plus Plan. xref 0000012102 00000 n endstream 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. This plan didn't cover prescription charges, office visit charges, medical equipment, psychiatric services, or other major medical services. Detroit, MI 48243. 172 0 obj Later in the year, that same person needs an MRI and chooses an out-of-network provider. 0000006930 00000 n Contact your auto insurance carrier for specific questions regarding PIP coverage. Your co-insurance amount for in-network services is 20%. 0000060102 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 0000003914 00000 n Ready to enroll? %%EOF Provided in a vehicle qualified as an ambulance and part of a licensed ambulance operation Members enrolled in the HSA plan will be responsible for paying an ER copayment after the deductible has been met. Simply . Because Mary's cost to have the HSA Plan is $0, her total cost is $3,030. 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. If you are new to an HMO, that HMO may ask you to select your primary care physician. Representatives are available 8:00 a.m. to 5:00 p.m., Monday through Friday. endobj 0000048277 00000 n 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). 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. 0000026660 00000 n No-fault auto insurance changes in Michigan | bcbsm.com New SHP PPO membership ID cards will be mailed in September 2019. When you combine Mary's cost to have and use the HSA Plus Plan, her total cost is $5,306. For Ford Employees: 2023 Health Plans | BCBSM You can log in to your online member account to see if you have a QHC letter to download. Respond promptly to the carrier to complete the final phase of the enrollment process. Qualified Transportation Fringe Benefits (QTFB). 0000035745 00000 n lC]n8\! 13 0 obj <> endobj Here's how these plans work. Please see below for further information. The HSA balance belongs to the employee and can be carried over from year to year. NO - YES - Please complete entire form, sign at the bottom and return sign at the bottom and return . 606 0 obj <>stream &yw}.$7eIw <<674A7177E0417F4590EC384E93D00AED>]>> With the total of all her family services and prescriptions, the HSA Plan costs $3,030 to use.

bcbsm qualified health coverage letter 2023