bcbsm qualified health coverage letter

<>stream If you choose to do so, you will be responsible for both deductibles. Your email address will not be published. 0000017479 00000 n You can also opt-out if you qualify for that provision. 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. 0000041020 00000 n PPO. If you absolutely need to call, please try again at a later date. 0000016284 00000 n %%EOF 0000028562 00000 n 0000022361 00000 n Be sure to turn off pop-up blocker and private browsing prior to opening your Auto Health verification letter. This provides cost and other information related to your plan options. 1200 N. Telegraph Road PDF State of Michigan 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 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. 119 0 obj The account and money are yours. Let's start with Mary who selected a plan to cover her family. Michigan Auto Insurance Reform -- What HAP Members Should Know To request your QHC confirmation letter: Log in to your member account. No-fault auto insurance changes in Michigan | bcbsm.com Log in to continue with member verification. 866-503-3158 Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. Thank you for viewing. 0000025874 00000 n You can log in to your online member account to see if you have a QHC letter to download. These plans also allow you to set aside tax-free funds that you can use for qualified medical expenses. For more information about the State of Michigan's eligibility requirements for employee health insurance coverage, . Auto insurance reform | Priority Health Look for the chat icon at the bottom right corner of the screenon any page of this website. This plan didn't cover prescription charges, office visit charges, medical equipment, psychiatric services, or other major medical services. em4MVRpH ~*.V%s^5h}R,uJXP;6s@bH{{J 4aWS8r *W~oKMwSV-Kl^voIb #TY^hAP38HUR{mv8azF`lAQm8yiKm77!}1nW 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 . 0000020133 00000 n 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 $3,006 out of pocket to use this plan. 0000029225 00000 n Once logged in, navigate to the https://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/no-fault-changes.html i' *eW 0000048540 00000 n 0000029999 00000 n 0000013667 00000 n Demographics |Electronic Data Interchange (EDI) | Recoveries, Need help with Provider Connection: Blue Shield Provider Connection Guide Provider Connection training. Members enrolled in the HSA plan will be responsible for paying an ER copayment after the deductible has been met. (MSPTA-represented only) You also have an out of pocket maximum, that's the maximum amount you pay in deductibles and applicable co-insurance during one plan year. 0000030241 00000 n endobj Blue Cross Blue Shield of Michigan. Share & Bookmark, Press Enter to show all options, press Tab go to next option, Retirement and Deferred Compensation Board, Upcoming Individual Consultations & Seminars, Oakland County's Qualified Health Coverage Letter for Active Employees, Oakland County's Qualified Health Coverage Letter for Retiree, Notice of Qualified Health Coverage for Purposes of Michigan No-Fault Auto Law, 2023 PPO 1 Summary of Benefits and Coverage, 2023 PPO 3 Summary of Benefits and Coverage, Summary of Information for Preventive Care, 2023 PPO 2 Summary of Benefits and Coverage, 2023 Traditional Summary of Benefits and Coverage, 2023 HAP Summary of Benefits and Coverage, BCBSM Approved Autism Evaluation Centers and Behavioral Analysts. \8/$z HSA Plan and HSA Plus Plan. 0000048349 00000 n Please provide the following information about the policy holder of the other health coverage. 0000048472 00000 n N'JV|DI]Ea:%*&[|{;z^HzwD/L_d?D/q|',W2tKpcukU;Bxc%w37XeNh{%_hl@zPMy * uAd;{i6pmn'D=6e Cvy"ngpdh6 s/8bG. For more info, visitwww.mi.gov/AutoInsurance, emailAutoInsurance@mi.gov, or call 833-ASK-DIFS (275-3437). endobj lC]n8\! Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. An HDHP offers a lower biweekly premium in exchange for higher deductibles and out-of-pocket limits. When you combine Mary's cost to have and use the HSA Plus Plan, her total cost is $5,306. h1aMXk* Q)DDJjH$*F After your deductible is met, co-insurance applies to medical and prescription costs until your out-of-pocket maximum is met. Visit myfordbenefits.com and make your plan selection for 2023. Thank you for viewing. 193 0 obj <>stream Field Service. 0000025213 00000 n <> 0000004937 00000 n Behavior Health/Substance Use Disorder Administrator. 0000012102 00000 n To help you compare and select your 2021 plan based on your personal needs, Ford has provided Benefits Mentor powered by IBM Watson Health. endstream You are encouraged to visit your benefit providers' website and create free member logins. 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 And you don't have to use the money by the end of the year, your account balance will not expire. 0000047030 00000 n hbbd```b``z"@$D2e5A$)e,H^0 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. 163 0 obj <>stream Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health Identified standard preventive services are covered at 100%, but most other services have a 20% in-network coinsurance after meeting the deductible. 0000018138 00000 n 0000007628 00000 n The network covers all 83 Michigan counties and is the largest PPO network in Michigan. 0000035745 00000 n Health Trust See below. 0000005858 00000 n 0000031415 00000 n 0000012476 00000 n 0000059434 00000 n State Health Plan PPO - Administered by Blue Cross Blue Shield of Michigan (BCBSM). 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. Because Mary's cost to have the HSA Plan is $0, her total cost is $3,030. NO - YES - Please complete entire form, sign at the bottom and return sign at the bottom and return . Your coverage is considered qualified if it: When making a decision, keep in mind that PIP has coverage that goes beyond traditional health insurance. GradCare Member Reimbursement Form U-M Premier Care Member Reimbursement Form Claims | Benefits | Member eligibility | How to use Provider Connection | Contracts | Credentialing | 0000014991 00000 n 0000016573 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. 0000017188 00000 n Learn More Questions? Try again later. There are several ways you can request a QHC letter. But, if you receive services from a provider not in the PPO network, you may be responsible for paying additional out-of-pocket costs. 0000015249 00000 n Representatives are available 8:00 a.m. to 5:00 p.m., Monday through Friday. .r~'J ms-oA&@i 9k2 J4T{Yt;cu6J_Fs"6r|(Z? 0000029515 00000 n Under the new legislation, residents may select different levels of PIP coverage. 0000048277 00000 n 0000011210 00000 n TTY users should call 711. 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 0000048207 00000 n Provider Connection Home | Blue Shield of CA Provider All rights reserved. Once logged in, navigate to the QHC letter in the Proof of Insurance section at the bottom of the page. XYQ This product provides comprehensive PPO coverage with costsharing features. Respond promptly to the carrier to complete the final phase of the enrollment process. Visit myfordbenefits.com and make your plan selection for 2023. Bcbsm Qualified Health Coverage Letter 0000042215 00000 n 0 0000059887 00000 n 606 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 Your explanation of benefits (EOB) statement has a new look. 0000033229 00000 n In 2021, you'll have a choice between two HSA eligible medical plans, HSA Plan and HSA Plus Plan. 0000034485 00000 n 0000019432 00000 n And for the HSA Plus Plan, it's $1,020. It has a deductible of $6,000 or less per person. General Inquiries. You don't need to wait until your new plan year starts to see your doctor. Individuals attempting unauthorized access will be prosecuted. 0000008905 00000 n You can call the number on the back of your member ID card. PDF Blue Cross Blue Shield of Michigan: Understanding member ID cards We're making your EOB easier to understand. You still have the freedom to go out-of-network to see any physician, hospital or other provider of your choice. Blue Cross Blue Shield of Michigan: Understanding member ID cards 0000010545 00000 n hm6?ZqJ!nv+E 0000048683 00000 n Please see below for further information. }v".VrTAmk$NJ+ y{i-Y#gds7D Please refer to www.bcbsm.com/som for the list of providers. 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. Here's how these plans work. 0000059656 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. 0000018397 00000 n 500 Renaissance Center. Preventive care benefits are covered 100 percent when received from a TRUST PPO network provider. Learnyour requirements, deadline dates and more about your coverage. 0000035230 00000 n Contact your auto insurance agent with questions and to learn more about your options. Those costs include increased copay and deductible amounts. The HSA Plan is available to you at no cost. *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). Qualified health coverage is health or accident insurance that doesn't exclude or limit coverage for injuries from auto accidents. Qualification Forms | Managing My Account | bcbsm.com 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. This plan provides health benefits using providers and facilities that are in-network, meaning the providers and facilities have agreed to accept a discounted fee from BCBSM in order to be in-network. [Instructor] Hello, and welcome to Blue Cross Blue Shield of Michigan. This copay is waived if Mary or her family member is admitted as a result of the ER visit. You may look up HMOs in your residential area using the zip code tool. 0000026163 00000 n a health reimbursement arrangement which helps members pay for qualified medical expenses. 0000011580 00000 n Log in to get your questions answered by a live representative, Monday through Friday, 6 a.m. to 6:30 p.m. They areresponsible for the deductible, then the hospital is reimbursed according to the plan design. 0000019062 00000 n This contribution will be prorated for employees who enroll mid-year. 0000027625 00000 n PDF Hospital Coverage Letter - Bcbstx 0000009647 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. View the eGuide to see the Ford resources available all year long. 577 0 obj <>stream 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. 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 . 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). Follow the instructions on the page to have your letter created. 0000003914 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. Detroit, MI 48243. Simply Blue. 258 0 obj <> endobj If you have additional BCBSM contracts, pleas e include this as other 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. 0 13 0 obj <> endobj 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 Members should direct specific questions about PIP coverage to their auto insurer. 0000010919 00000 n Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health 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. This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. The plan covers inpatient hospital care, as well as other outpatient services received at a hospital including emergency room care. Or, call the number on the back of your member ID card. Qualified Healthcare Coverage Letter 0000048916 00000 n *Blue Shield of California member plans only. PIP coverage can include items like attendant care, housing modifications and lost wages. 0000023276 00000 n 1-313-225-9000. To quickly and easily find out if you, the provider, or a provider referral, participate in the member's plan network*, either log in or register for Provider Connection. And he pay $2,280 annually to have the HSA Plus Plan. Take a look at what Blue Cross plans offer, then choose the one that's right for you. 0000027006 00000 n Go paperless by submitting claims and managing payments online for free. Co-insurance is a percentage of the cost you share with the plan. 0000048834 00000 n 0000008243 00000 n SECTION 2 OTHER HEALTH COVERAGE INFORMATION . New SHP PPO membership ID cards will be mailed in September 2019. <. Difs Qualified Health Care Letter 0000048409 00000 n hb``a`` -mY8PE!u[dCC#W6,j.Fvtl,s fb`p;CT3j Effective January 1, 2023, MSPTA-represented (To1) employees are eligible for this benefit, DROP employees and OEAIs and the dependents remain ineligible. 800-229-2210 0000023650 00000 n View detailed plan information in this document. 0000030725 00000 n To help your savings grow even more, when your HSA balance reaches $1,000, you can choose a variety of investments.