startxref "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. 0 This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. 0000010545 00000 n 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. For more information about the State of Michigan's eligibility requirements for employee health insurance coverage, . Available for commercial, Shared Advantage, and BlueCard. db4H@g& C 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. Submit and confirm authorizations and approval of medical and pharmacy services prior to services being rendered. Depending the level of PIP you choose, your auto insurer may request a letter stating whether you have qualified health coverage, or QHC. 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. $158 per month) Eligibility: All MSU students, Law students, Visiting scholars, and more, including spouse and children of a student enrolled in the plan. 0000029515 00000 n Detroit, MI 48243. <>stream And with the HSA Plus Plan, Ford will also contribute to your HSA. PIP pays for services that health insurance may or may not cover. Health Insurance Marketplace Check out information about the Marketplace, especially if you are not eligible for coverage through LCC. 0000004052 00000 n Under the plan documents section, click Michigan Auto Reform to request a letter be mailed to the subscriber's address. hm6?ZqJ!nv+E We appreciate your understanding. Your Benefit Guide State Health Plan PPO 3 Visit BCBSM Customer Service Center 232 S. Capitol Ave. Lansing, MI 48933 . The network covers all 83 Michigan counties and is the largest PPO network in Michigan. 0000020507 00000 n 0000008446 00000 n State-sponsored health insurance carriers are prepared to send a letter to State employees or retirees, upon request, confirming their health plan is considered Qualified Health Coverage (QHC). 0000027783 00000 n 0000032096 00000 n 0000035745 00000 n endobj Click My Plan and Spending. To find the most up-to-date information about current medical and pharmacy claims, you can use the Blue Cross app or log into your BCBSM member account at bcbsm.com. 1200 N. Telegraph Road 0000022070 00000 n TTY users should call 711. It can help treat minor illnesses such as colds, sinus or respiratory infections, sprains, or rashes, making it perfect when your primary care physician is unavailable or leaving the house is difficult. 0000033229 00000 n 0 0000028562 00000 n Healthcare includes your Medical (ASR, BCBS, or HAP), Prescription (Navitus or HAP), Dental (Delta Dental), and Vision (NVA). We can help. 0000005259 00000 n hbbd``b`$WX@]@D0(, IH0@1% b Cu@\v d"3|` And you don't have to use the money by the end of the year, your account balance will not expire. In our next scenario, James covers his wife on his medical plan. 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. 0000049042 00000 n 0000026478 00000 n <<674A7177E0417F4590EC384E93D00AED>]>> State Health Plan PPO - Administered by Blue Cross Blue Shield of Michigan (BCBSM). 193 0 obj <>stream 0000059965 00000 n GradCare Member Reimbursement Form U-M Premier Care Member Reimbursement Form For the HSA Plus Plan, Ford contributes $1,000 towards Mary's health savings account, which further reduces her cost to use this plan. BlueCard Program home page. An HSA is a smart way to save for your future qualified health expenses, including those that may come up in retirement. Be informed about all your Blue Cross plan has to offer. An HDHP offers a lower biweekly premium in exchange for higher deductibles and out-of-pocket limits. Visit, Go to Qualified Transportation Fringe Benefits (QTFB), Active Employee State Health Plan PPO BCBSM Plan Booklet, Retiree State Health Plan PPO With Medicare Booklet, Understanding HMO Insurance Premium Rates. California Physicians Service DBA Blue Shield of California 1999-2023. MSU Student Health Insurance Plan. You can log in to your online member account to see if you have a QHC letter to download. 0000048613 00000 n Automobile No-Fault Insurance Changes: Prior to July 2, 2020, Michigans Automobile No-Fault Insurance Law required individuals to purchase unlimited Personal Injury Protection (PIP) through their auto insurer. Learn More Questions? You can call the number on the back of your member ID card. h1aMXk* Q)DDJjH$*F 0000010306 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. And for the HSA Plus Plan, it's $1,020. IS IBCQ-]97T5dUa{ugdcg`\o'.Nu }n|7G|ZXXMf9I\RTt K{d\H3$]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. To help you compare and select your 2021 plan based on your personal needs, Ford has provided Benefits Mentor powered by IBM Watson Health. 0000048976 00000 n 0000010919 00000 n Visit myfordbenefits.com and make your plan selection for 2023. And he pay $2,280 annually to have the HSA Plus Plan. 0000029757 00000 n endstream endobj 14 0 obj <. 'TMjZ}dM`V;hO0 45o` T@> $0,Tkpp9~#@="-toen7=u-J 3P6sO1v 0IA||$IRs3R6o'j*vU#;B!FL5O,hBtA7|$xVv)*09KTOM8Gh6CAIT,[*6a8 wz Follow the instructions on the page to have your letter created. 0000031112 00000 n This means you have the option to increase your payroll contributions so you can reach the maximum contribution amount earlier in the year. PPO. Look for the chat icon at the bottom right corner of the screenon any page of this website. 1tv %PDF-1.6 % Access tools to prescreen, submit and check the status of submitted claims. 0000023650 00000 n There are different levels of PIP coverage that you can choose from. 0000008243 00000 n Provided in a vehicle qualified as an ambulance and part of a licensed ambulance operation Physician Qualification Form (PDF) Healthy Blue Achieve Form John's annual paycheck deduction for the HSA Plan is zero. 0000042215 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). The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. 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. 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. The document must: After your deductible is met, co-insurance applies to medical and prescription costs until your out-of-pocket maximum is met. 0000017479 00000 n You don't need to wait until your new plan year starts to see your doctor. TVxZOEhL5wV/yZP^',UP1ko}87M@p_[8Sq^R/ 0000048277 00000 n Later in the year, that same person needs an MRI and chooses an out-of-network provider. XYQ This product provides comprehensive PPO coverage with costsharing features. Your co-insurance amount for in-network services is 20%. Simply Blue. 0000048472 00000 n James wouldn't have to pay anything from his paycheck to have the HSA Plan. Log in to get your questions answered by a live representative, Monday through Friday, 6 a.m. to 6:30 p.m. 0000017849 00000 n Visit myfordbenefits.com and make your plan selection for 2023. Learn about our tools and how to use them in our upcoming webinars. 0000044573 00000 n For example: a single person chooses an in-network hospital for surgery. 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. 866-503-3158 Co-insurance is a percentage of the cost you share with the plan. *Except for those employees in certain bargaining units who are hired on or after 1/1/00 who have a regular work schedule of 40 hours or less per bi-weekly pay period (not permanent-intermittent positions). Blue Cross Blue Shield of Michigan, in partnership with Lucet 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. em4MVRpH ~*.V%s^5h}R,uJXP;6s@bH{{J 4aWS8r *W~oKMwSV-Kl^voIb #TY^hAP38HUR{mv8azF`lAQm8yiKm77!}1nW hb``b``f`c`Taa@ V(-) Q>hL)[ley|800pt Pn`K Al@8m@@3J31k=21@=3 F%&hWfpdbm]` 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. endstream [Narrator] Hello again, and welcome to Blue Cross Blue Shield of Michigan. This tool provides side-by-side medical plan comparisons and personalized cost modeling. Members should direct specific questions about PIP coverage to their auto insurer. The network covers all 83 Michigan counties and is the largest PPO network in Michigan. Respond promptly to the carrier to complete the final phase of the enrollment process. The Plan also covers most of your community-based care (office visits), as well as necessary medical equipment and supplies (crutches, hearing aids, etc.). 163 0 obj <>stream lo%x9d,oqM lzgw'TK6oB~+d; {qi.B/ R`]Hcq6~s_]=y&|9]Fl2b\o9Vp"(5Z9lb.dx;@? *Mii lkSW+0XI~'kT`C>?wlvR 0000017188 00000 n Qualified Transportation Fringe Benefits (QTFB). 0000012767 00000 n 0000059656 00000 n lC]n8\! What's qualified health coverage under the new law? a health reimbursement arrangement which helps members pay for qualified medical expenses. General Inquiries. 0000032373 00000 n endstream 0000028854 00000 n 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. Your doctor will submit the form by following the instructions on the back. Detroit, MI 48226-9942. 0000026848 00000 n (MSPTA-represented only) 0000059211 00000 n 0000013137 00000 n The State Health Plan PPO provides reimbursement for medical care expenses when you need treatment for an illness, injury, or disease. Ready to enroll? Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. Now let's look at some helpful scenarios that show how these plans work, considering the costs to have and use each plan. Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. We're redirecting you to Blue Shield of California's Find a doctor search. When asked to log in, choose Continue as a guest. 0000041020 00000 n 0000009279 00000 n %%EOF 0000014991 00000 n The HSA balance belongs to the employee and can be carried over from year to year. 0000025874 00000 n 0000048173 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. 0000045752 00000 n 0000007848 00000 n 0000015914 00000 n Don't have a member account? 0000034422 00000 n b|=b}#Aif3TRD0;@NHkQ#`VEQxD 0000018138 00000 n Pontiac, MI 48341. $"mY_%Be66y=\"QI Log in to continue with member verification. Effective January 1, 2023, MSPTA-represented (To1) employees are eligible for this benefit, DROP employees and OEAIs and the dependents remain ineligible. 0000027161 00000 n Contact your auto insurance agent with questions and to learn more about your options. trailer 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. The out-of-pocket maximum does not include monthly paycheck contributions, copayments, or any expenses not covered by your plan. Create an account now. These plans also allow you to set aside tax-free funds that you can use for qualified medical expenses. No-fault auto insurance changes in Michigan bcbsm.com Health (6 days ago) WebThere are several ways you can request a QHC letter. 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 Please refer to www.bcbsm.com/som for the list of providers. This tool provides side-by-side medical plan comparisons and personalized cost modeling. Ford offers an accelerated contribution option. In 2021, you'll have a choice between two HSA eligible medical plans, HSA Plan and HSA Plus Plan. 0000013426 00000 n When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. Health Trust 0000036634 00000 n Since John has individual coverage, he gets a $500 HSA contribution from Ford if he selects the HSA Plus Plan, Ford doesn't make a contribution towards the health savings account for the HSA Plan. It has more than 20,000 physicians, including specialists, and more than 140 all acute care hospitals in Michigan. 0000006680 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. 0000019432 00000 n The plan covers inpatient hospital care, as well as other outpatient services received at a hospital including emergency room care. 120 0 obj Your explanation of benefits (EOB) statement has a new look. You can also opt-out if you qualify for that provision. 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. 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. &yw}.$7eIw 0000003382 00000 n 0000038624 00000 n If you have additional BCBSM contracts, pleas e include this as other coverage. Behavior Health/Substance Use Disorder Administrator. 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. 0000024600 00000 n 172 0 obj Qualified health coverage is health or accident insurance that doesn't exclude or limit coverage for injuries from auto accidents. 0000016573 00000 n 13 151 0000026660 00000 n James has arthritis, so he needs to take a higher cost maintenance drug. To help your savings grow even more, when your HSA balance reaches $1,000, you can choose a variety of investments. <>/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 %PDF-1.7 % endobj If you are new to an HMO, that HMO may ask you to select your primary care physician. Now let's look at what a single person with relatively few healthcare needs might experience. Let's say Mary and her family have a normal year with normal doctor visits. Before you select a medical plan, consider your total costs, including the costs to have and use the plan. If you choose to do so, you will be responsible for both deductibles. 258 0 obj <> endobj Log in now myfordbenefits.com HELPS YOU: View personalized benefits To help you compare and select your 2021 medical plan, Ford has provided Benefits Mentor powered by IBM Watson Health. New SHP PPO membership ID cards will be mailed in September 2019. Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader, Important Information About MedicarePlans. PIP coverage can include items like attendant care, housing modifications and lost wages. 0000048834 00000 n 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. 0000007258 00000 n In the HSA Plus Plan, you're also responsible for all medical and prescription costs until your deductible is met.
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