(MSPTA-represented only) 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. 0 Please refer to www.bcbsm.com/som for the list of providers. Current SHP PPO enrollees will be automatically transitioned with no gap or changes in coverage. You can keep your unlimited PIP coverage. Go paperless by submitting claims and managing payments online for free. Ford offers an accelerated contribution option. <<674A7177E0417F4590EC384E93D00AED>]>> For the HSA Plan, your deductible and out-of-pocket maximum amounts for in-network services are the same. 0000027006 00000 n | _1S}9M{T=o9B^>.!a8Znpk9(6_ View detailed plan information in this document. Enter the three letters of your "Enrollee ID" found on your Blue Cross Blue Shield member ID card, and then click Go. We appreciate your understanding. You may look up HMOs in your residential area using the zip code tool. xref 0000012476 00000 n 0000009279 00000 n 0000022731 00000 n 0000006930 00000 n The maximum deductible for two or more covered persons in your family was limited to 1 months of your basic salary. Other costs to use the HSA Plan will vary depending on whether you select plan coverage for you or for your family. 0000059656 00000 n If you have any questions, call the phone number on the back of your Blue Cross ID card and we'll help. 0000024839 00000 n 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 If you have additional BCBSM contracts, pleas e include this as other coverage. 0000008905 00000 n %PDF-1.7 % 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 . Qualified health coverage is health or accident insurance that doesn't exclude or limit coverage for injuries from auto accidents. 0000023020 00000 n They areresponsible for the deductible, then the hospital is reimbursed according to the plan design. 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. 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. 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 $2,480. 0000036168 00000 n }v".VrTAmk$NJ+ y{i-Y#gds7D 1-313-225-9000. Members should direct specific questions about PIP coverage to their auto insurer. 0000004500 00000 n 0000007848 00000 n 310 0 obj <>/Filter/FlateDecode/ID[<4C51D19B138643B1A2CB07133610D1D7>]/Index[258 116]/Info 257 0 R/Length 203/Prev 1461330/Root 259 0 R/Size 374/Type/XRef/W[1 3 1]>>stream 0000026320 00000 n To help you compare and select your 2021 medical plan, Ford has provided Benefits Mentor powered by IBM Watson Health. 0000029757 00000 n hm6?ZqJ!nv+E 0000043394 00000 n [Narrator] Hello again, and welcome to Blue Cross Blue Shield of Michigan. We'll accept a qualification form from an office visit that occurred up to 180 days before the start of your plan year. 0000047030 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. db4H@g& C Please review directory information to ensure its accuracy before attesting. trailer All rights reserved. Thank you for viewing. You are encouraged to visit your benefit providers' website and create free member logins. For the HSA Plus Plan, her yearly contributions, which is her cost to have the plan would be $3,300. This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. Contact your auto insurance carrier for specific questions regarding PIP coverage. Learn about our tools and how to use them in our upcoming webinars. This plan covered inpatient hospital expenses, as well as certain other services received at the hospital on an outpatient basis (including emergency room care). 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. 0000009647 00000 n 0000044573 00000 n 0000004148 00000 n 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 0000034485 00000 n 0000028854 00000 n If you choose to do so, you will be responsible for both deductibles. For the best experience, use the latest version of Google Chrome or Microsoft Edge. Two letters confirming you have MESSA coverage that are often requested by your auto insurance carrier can be found in your MyMESSA member account. (tJ)Dpdd5* 7YG1}[X3C=Yvou*tdU`{NRGqZy3Cv{c.W+5gE|7?)z 120 0 obj Let's say Mary and her family have a normal year with normal doctor visits. This tool provides side-by-side medical plan comparisons and personalized cost modeling. Simply Blue. 0000019062 00000 n 0000038624 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. h1aMXk* Q)DDJjH$*F Please provide the following information about the policy holder of the other health coverage. And for the HSA Plus Plan, it's $1,020. 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. It has a deductible of $6,000 or less per person. The network covers all 83 Michigan counties and is the largest PPO network in Michigan. 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. .r~'J ms-oA&@i 9k2 J4T{Yt;cu6J_Fs"6r|(Z? 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. 0000008243 00000 n 0000048409 00000 n We're redirecting you to Blue Shield of California's Find a doctor search. The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. 0000045752 00000 n em4MVRpH ~*.V%s^5h}R,uJXP;6s@bH{{J 4aWS8r *W~oKMwSV-Kl^voIb #TY^hAP38HUR{mv8azF`lAQm8yiKm77!}1nW This contribution will be prorated for employees who enroll mid-year. hb``b``f`c`Taa@ V(-) Q>hL)[ley|800pt Pn`K Al@8m@@3J31k=21@=3 F%&hWfpdbm]` 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 "$6,000 or less per individual." (MCL 500.3107d (7) (b) (i)) Or it is Medicare coverage. To find the most up-to-date information about current medical and pharmacy claims, you can use the Blue Cross app or log into your BCBSM member account at bcbsm.com. 0000010545 00000 n 258 0 obj <> endobj 0rtq]%g=z.#i0\*m(D2q;t2}$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=. In 2021, you'll have a choice between two HSA eligible medical plans, HSA Plan and HSA Plus Plan. The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. PIP pays for services that health insurance may or may not cover. Take a look at what Blue Cross plans offer, then choose the one that's right for you. Utilize the Insurance Planspage to review plan summaries or contact the HMO that interests you to request their benefit booklet. And he pay $2,280 annually to have the HSA Plus Plan. 0000010919 00000 n Your co-insurance amount for in-network services is 20%. Log in now myfordbenefits.com HELPS YOU: View personalized benefits \8/$z For more info, visitwww.mi.gov/AutoInsurance, emailAutoInsurance@mi.gov, or call 833-ASK-DIFS (275-3437). You can log in to your online member account to see if you have a QHC letter to download. An important note regarding the State Health Plan PPO deductibles: You have the freedom to see both in-network and out-of-network providers. Questions About Your Benefits? Healthcare includes your Medical (ASR, BCBS, or HAP), Prescription (Navitus or HAP), Dental (Delta Dental), and Vision (NVA). You can log in to your online member account to see if you have a QHC letter to download. 0000025874 00000 n The document must: Visit myfordbenefits.com and make your plan selection for 2023. For all other claims, choose your health plan on this page to find the form and instructions for sending it in. $"mY_%Be66y=\"QI <. 0000032777 00000 n lC]n8\! Employees can now get a Health Care Plan Verification letter through Wolverine Access by selecting Employee Self-Service > Benefits > Health Care Plan Verification. After that deductible is met, out-of-network charges are paid according to the plan design. What does PIP cover? 0 0000027945 00000 n Under the plan documents section, click Michigan Auto Reform to request a letter be mailed to the subscriber's address. 0000034422 00000 n 0000048207 00000 n 0000004937 00000 n 0000025213 00000 n 0000035745 00000 n 0000048277 00000 n 0000028562 00000 n 0000024311 00000 n 0000021168 00000 n Co-insurance is a percentage of the cost you share with the plan. 0000041020 00000 n 0000048472 00000 n 0000060222 00000 n 0000007421 00000 n Select Claims on the menu bar. First, let's look at the cost to have a medical plan. 0000035230 00000 n BlueCard Program home page. These scenarios are simple, and there are many other ways you can consider managing your out-of-pocket costs with your health savings account. Blue Cross Blue Shield of Michigan: Understanding member ID cards 0000006145 00000 n 0000059211 00000 n 0000016284 00000 n Once logged in, navigate to the https://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/no-fault-changes.html 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. We can help. Later in the year, that same person needs an MRI and chooses an out-of-network provider. We're making your EOB easier to understand. 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. The out-of-pocket maximum does not include monthly paycheck contributions, copayments, or any expenses not covered by your plan. This plan didn't cover prescription charges, office visit charges, medical equipment, psychiatric services, or other major medical services. James wouldn't have to pay anything from his paycheck to have the HSA Plan. The State Health Plan PPO provides reimbursement for medical care expenses when you need treatment for an illness, injury, or disease. Look for the chat icon at the bottom right corner of the screenon any page of this website. Now let's look at some helpful scenarios that show how these plans work, considering the costs to have and use each plan. For Medicare Members: No-fault auto law changes bcbsm.com Health (Just Now) WebThere are several ways you can request a QHC letter. An HMO is a managed care plan that provides medical care through its network of physicians, pharmacies, contracted hospitals, and medical care suppliers. 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. Blue Cross Blue Shield of Michigan. 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. 0000026163 00000 n [Instructor] Hello, and welcome to Blue Cross Blue Shield of Michigan. 172 0 obj James has arthritis, so he needs to take a higher cost maintenance drug. Find information about Promise Medi-Cal and Cal MediConnect, our policies, procedures and programs. 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. 0000013137 00000 n 0000013426 00000 n %%EOF PIP coverage can include items like attendant care, housing modifications and lost wages. startxref endstream endobj startxref Your doctor will submit the form by following the instructions on the back. Uses standard Blue Cross ID card. 0000020133 00000 n 0000003914 00000 n Access tools to prescreen, submit and check the status of submitted claims. 163 0 obj <>stream 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. If you don't have a Provider Connection account, you will need to register before logging in. 0000017188 00000 n You're now aware you have a choice between two HSA eligible medical plans in 2021. Government Human Resources Benefits Health Benefit Plans. And you don't have to use the money by the end of the year, your account balance will not expire. 0000006680 00000 n Individuals attempting unauthorized access will be prosecuted. 119 0 obj 0000011869 00000 n Available for commercial, Shared Advantage, and BlueCard. Employees can also make pre-tax HSA contributions by payroll deductions. If you absolutely need to call, please try again at a later date. a health reimbursement arrangement which helps members pay for qualified medical expenses. He paid the full $800 cost of his medical services because the cost is less than the deductible for either plan. 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. Michigans new auto no-fault insurance law went into effect July 1, 2020. 0000059434 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 0000007258 00000 n ^0} SX XD00{03pi`p. 0000048349 00000 n Blue Shield/Blue Shield Promise network referrals. TTY users should call 711. To help you compare and select your 2021 plan based on your personal needs, Ford has provided Benefits Mentor powered by IBM Watson Health. Enroll when you're ready. Be informed about all your Blue Cross plan has to offer. They won't charge you the difference between their normal charge and the amount paid by the State Health Plan PPO. #G:&#WeKo]b287X]4 fd!n>X3jG[)GW%0.{1,JqA]Vf,fyf#Ji+OvDUpe!K|\"e2{g3ePW?/p 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. 0000023276 00000 n Now let's look at what a single person with relatively few healthcare needs might experience. Providers and facilities that fail to comply will be suppressed from our directories. Depending the level of PIP you choose, your auto insurer may request a letter stating whether you have qualified health coverage, or QHC. They are responsible for the out-of-network deductible. 0 0000005625 00000 n endobj For Medicare Members: No-fault auto law changes Health (Just Now) WebThere are several ways you can request a QHC letter. 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. endstream endobj 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 And with the HSA Plus Plan, Ford will also contribute to your HSA. 0000049102 00000 n 0000049165 00000 n *Blue Shield of California member plans only, Pre-service review for out-of-area members. 0000012102 00000 n Even though this law has to do with your auto insurance, a lot of people have questions about what it means for your. Identified standard preventive services are covered at 100%, but most other services have a 20% in-network coinsurance after meeting the deductible. 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). 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). %%EOF 'TMjZ}dM`V;hO0 45o` T@> $0,Tkpp9~#@="-toen7=u-J 3P6sO1v 0IA||$IRs3R6o'j*vU#;B!FL5O,hBtA7|$xVv)*09KTOM8Gh6CAIT,[*6a8 wz 1tv With the HSA Plan, you pay 100% of medical and prescription costs until your deductible is met. Physician Qualification Form (PDF) Healthy Blue Achieve Form Telemedicine Benefit Summary:Telemedicine visits allow you to meet with a US board-certified doctor online using a video-chat tool. 0000019432 00000 n New SHP PPO membership ID cards will be mailed in September 2019. Click continue to proceed with verification. 0000058981 00000 n We provide health insurance in Michigan. 0000017849 00000 n 0000005441 00000 n 0000015249 00000 n 0000048976 00000 n View the eGuide to see the Ford resources available all year long. 0000048916 00000 n 0000051836 00000 n 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. 0000004052 00000 n California Physicians Service DBA Blue Shield of California 1999-2023. John's annual paycheck deduction for the HSA Plan is zero. Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. Log in to continue with member verification. See your 2023 Benefits-at-a-Glance (PDF) for more plan details. Respond promptly to the carrier to complete the final phase of the enrollment process. An HDHP offers a lower biweekly premium in exchange for higher deductibles and out-of-pocket limits. Health Trust Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health Click My Plan and Spending. 0000049042 00000 n Those costs include increased copay and deductible amounts. We're sorry, but the attestation service is temporarily unavailable. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. 0000003382 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. Use the Find-a-Doctor tool to verify provider participation in one of our plan networks. Once they've been met, the plan generally pays the full amount of your in-network medical and prescription costs. 866-503-3158 Log in to get your questions answered by a live representative, Monday through Friday, 6 a.m. to 6:30 p.m. 0000007100 00000 n Benefits under this plan were payable only after you had paid expenses equal to one month's basic salary (your deductible). There are several ways you can request a QHC letter. 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. 0000059887 00000 n As you can see, there are great benefits to having an HSA. 0000048755 00000 n 0000018138 00000 n 13 0 obj <> endobj 0000039800 00000 n Contact your auto insurance agent with questions and to learn more about your options. 0000026660 00000 n 0000014041 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. After your deductible is met, co-insurance applies to medical and prescription costs until your out-of-pocket maximum is met. 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. *Note: MSPTA-represented (T01) employees, DROP employees, and Other Eligible Adult Individuals (OEAIs) and their dependents are not eligible for this benefit. 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. 0000019721 00000 n 0000009570 00000 n Thank you for viewing. %%EOF The HSA Plan is available to you at no cost. No-fault auto insurance changes in Michigan bcbsm.com Health (6 days ago) WebThere are several ways you can request a QHC letter. Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health %PDF-1.7 % You can log in to your online member account to see if you have a QHC letter to download. 0000007628 00000 n The deductible is the amount you pay before your plan contributes to your costs. 0000008045 00000 n The account and money are yours. 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. 0000031798 00000 n startxref 500 Renaissance Center. An HSA is a smart way to save for your future qualified health expenses, including those that may come up in retirement.
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bcbsm qualified health coverage letter