Later in the year, that same person needs an MRI and chooses an out-of-network provider. %PDF-1.6 % A plan is considered QHC if coverage for motor vehicle accidents is not excluded and the annual deductible is $6,000 or less per covered individual. Per state and federal law, providers and facilities must attest to accuracy of directory information to stay visible in find a Doctor. If you need information about eligibility, benefits or claims, or want to submit or review an authorization, the best way to get up-to-date information is through our on-line resources. 0000031415 00000 n *Blue Shield of California member plans only. Share & Bookmark, Press Enter to show all options, press Tab go to next option, Retirement and Deferred Compensation Board, Upcoming Individual Consultations & Seminars, Oakland County's Qualified Health Coverage Letter for Active Employees, Oakland County's Qualified Health Coverage Letter for Retiree, Notice of Qualified Health Coverage for Purposes of Michigan No-Fault Auto Law, 2023 PPO 1 Summary of Benefits and Coverage, 2023 PPO 3 Summary of Benefits and Coverage, Summary of Information for Preventive Care, 2023 PPO 2 Summary of Benefits and Coverage, 2023 Traditional Summary of Benefits and Coverage, 2023 HAP Summary of Benefits and Coverage, BCBSM Approved Autism Evaluation Centers and Behavioral Analysts. For the HSA Plan, your deductible and out-of-pocket maximum amounts for in-network services are the same. The network covers all 83 Michigan counties and is the largest PPO network in Michigan. Log in to get your questions answered by a live representative, Monday through Friday, 6 a.m. to 6:30 p.m. em4MVRpH ~*.V%s^5h}R,uJXP;6s@bH{{J 4aWS8r *W~oKMwSV-Kl^voIb #TY^hAP38HUR{mv8azF`lAQm8yiKm77!}1nW IS IBCQ-]97T5dUa{ugdcg`\o'.Nu }n|7G|ZXXMf9I\RTt K{d\H3$]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. Ford offers an accelerated contribution option. 0000010306 00000 n Visit myfordbenefits.com and make your plan selection for 2023. Under the plan documents section, click Michigan Auto Reform to request a letter be mailed to the subscriber's address. 0000059656 00000 n lC]n8\! 0000027006 00000 n Click My Plan and Spending. 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. <<674A7177E0417F4590EC384E93D00AED>]>> 0000059211 00000 n Learn More Questions? 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. 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. After that deductible is met, out-of-network charges are paid according to the plan design. You can now file disputes, attach supporting documents, and retrieve letters for submitted disputes online! To request your QHC confirmation letter: Log in to your member account. Once logged in, navigate to the https://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/no-fault-changes.html The deductible is the amount you pay before your plan contributes to your costs. 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 PDF State of Michigan <> Click continue to proceed with verification. endstream 0000023276 00000 n xref 0000012476 00000 n 0000025874 00000 n Medicare | Claim Forms | bcbsm.com Qualified Healthcare Coverage Letter HSA Plan and HSA Plus Plan. 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. Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health Mary would pay nothing from her paycheck to have the HSA Plan. Both plans include a health savings account HSA. Please enable JavaScript in your browser for a better user experience. Please see below for further information. 0000027473 00000 n Pontiac, MI 48341. "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. You can log in to your online member account to see if you have a QHC letter to download. 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. TTY users should call 711. 0000032373 00000 n 0000014991 00000 n Thank you for viewing. <>/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 0000005259 00000 n endobj 0000032096 00000 n endobj db4H@g& C To help you compare and select your 2021 medical plan, Ford has provided Benefits Mentor powered by IBM Watson Health. After your deductible is met, co-insurance applies to medical and prescription costs until your out-of-pocket maximum is met. Bcbsm Qualified Health Coverage Letter 0000005441 00000 n The maximum deductible for two or more covered persons in your family was limited to 1 months of your basic salary. 0000011869 00000 n The Plan also covers most of your community-based care (office visits), as well as necessary medical equipment and supplies (crutches, hearing aids, etc.). For the best experience, use the latest version of Google Chrome or Microsoft Edge. Need a Health Care Plan Verification Letter for Your Auto Insurance The HSA Plan is available to you at no cost. As you can see, there are great benefits to having an HSA. Once they've been met, the plan generally pays the full amount of your in-network medical and prescription costs. 0000020507 00000 n 0000030241 00000 n *Blue Shield of California member plans only, Pre-service review for out-of-area members. Contact your auto insurance carrier for specific questions regarding PIP coverage. 500 Renaissance Center. 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. 0000013426 00000 n Preventive care benefits are covered 100 percent when received from a TRUST PPO network provider. 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. There are several ways you can request a QHC letter. 0000028854 00000 n Two letters confirming you have MESSA coverage that are often requested by your auto insurance carrier can be found in your MyMESSA member account. To help your savings grow even more, when your HSA balance reaches $1,000, you can choose a variety of investments. 577 0 obj <>stream Thank you for viewing. 0000025504 00000 n New SHP PPO membership ID cards will be mailed in September 2019. 0000024839 00000 n You don't need to wait until your new plan year starts to see your doctor. So when we consider the total cost to have and use the plans, the HSA Plus Plan is the less costly option. State Health Plan Preferred Provider Organization (PPO) James has arthritis, so he needs to take a higher cost maintenance drug. 0000027316 00000 n Qualified Transportation Fringe Benefits (QTFB). The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. endstream endobj startxref Michigans new auto no-fault insurance law went into effect July 1, 2020. Coordination of Benefits Questionnaire - BCBSM 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 This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. (MSPTA-represented only) You can log in to your online member account to see if you have a QHC letter to download. 0000022731 00000 n 0000030483 00000 n %%EOF Your Benefit Guide State Health Plan PPO 3 Visit BCBSM Customer Service Center 232 S. Capitol Ave. Lansing, MI 48933 . Take a look at what Blue Cross plans offer, then choose the one that's right for you. 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 . PDF BCBSM Master Medical Claim Form <>stream Please provide the following information about the policy holder of the other health coverage. 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. 0000007848 00000 n %PDF-1.6 % Health Plan Details Now let's look at some helpful scenarios that show how these plans work, considering the costs to have and use each plan. It has more than 20,000 physicians, including specialists, and more than 140 all acute care hospitals in Michigan. 0000013137 00000 n 0000048173 00000 n \8/$z Your doctor will submit the form by following the instructions on the back. 0000048683 00000 n 0 This contribution will be prorated for employees who enroll mid-year. Look for the chat icon at the bottom right corner of the screenon any page of this website. 0000025213 00000 n 0000010545 00000 n It has more than 20,000 physicians, including specialists, and more than 140 all acute care hospitals in Michigan. An HMO is a managed care plan that provides medical care through its network of physicians, pharmacies, contracted hospitals, and medical care suppliers. 0000043394 00000 n (tJ)Dpdd5* 7YG1}[X3C=Yvou*tdU`{NRGqZy3Cv{c.W+5gE|7?)z 0000026163 00000 n %%EOF 0000034422 00000 n 0000034448 00000 n Where does my client go to get a Qualified Health Coverage (QHC) letter 0000047030 00000 n 0000008674 00000 n 0000027945 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. Visit myfordbenefits.com and make your plan selection for 2023. 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 Qualified health coverage is health or accident insurance that doesn't exclude or limit coverage for injuries from auto accidents. 0000033132 00000 n 0000006389 00000 n 606 0 obj <>stream You can also take a closer look at your current plan to help you make the best choice for your 2021 plan. [Instructor] Hello, and welcome to Blue Cross Blue Shield of Michigan. And for the HSA Plus Plan, it's $1,020. hm6?ZqJ!nv+E View the eGuide to see the Ford resources available all year long. 0000029999 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. The HSA balance belongs to the employee and can be carried over from year to year. For the HSA Plus Plan, Ford contributes $1,000 towards Mary's health savings account, which further reduces her cost to use this plan. 0000029225 00000 n This tool provides side-by-side medical plan comparisons and personalized cost modeling. 0000033229 00000 n Follow the instructions on the page to have your letter created. When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. Your email address will not be published. No-fault auto insurance changes in Michigan bcbsm.com Health (6 days ago) WebThere are several ways you can request a QHC letter. 866-503-3158 0000023941 00000 n Depending the level of PIP you choose, your auto insurer may request a letter stating whether you have qualified health coverage, or QHC. 0000020133 00000 n We're redirecting you to Blue Shield of California's Find a doctor search. Demographics |Electronic Data Interchange (EDI) | Recoveries, Need help with Provider Connection: Blue Shield Provider Connection Guide Provider Connection training. 0000016573 00000 n Your explanation of benefits (EOB) statement has a new look. The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. You are encouraged to visit your benefit providers' website and create free member logins. 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. i' *eW 0000027161 00000 n %%EOF Letters for your auto insurance carrier - MESSA Michigan Auto Insurance Reform -- What HAP Members Should Know &yw}.$7eIw 0000022070 00000 n Employees can now get a Health Care Plan Verification letter through Wolverine Access by selecting Employee Self-Service > Benefits > Health Care Plan Verification. 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. You have certain tasks to complete within specific . 0000021168 00000 n Blue Shield/Blue Shield Promise network referrals. Give us a call to discuss your plan options. This means you have the option to increase your payroll contributions so you can reach the maximum contribution amount earlier in the year. Member logins offer many on-line tools, such as access to claims information, viewing Explanation of Benefits, printing replacement ID cards, etc. 0000048207 00000 n 0000026848 00000 n This amount does not count toward the plan's out-of-pocket maximum. Available for commercial, Shared Advantage, and BlueCard. 0000003914 00000 n Links to all provider websites can be found on our Benefit Carrier Contact Information page. PDF Best of Health Medicare 141 0 obj 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 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. When we look again at the total cost of having and using the plans, the HSA Plan is the lower cost option for John. 0000019892 00000 n 0000006145 00000 n Learn about our tools and how to use them in our upcoming webinars. 0000049042 00000 n 0000016814 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. We're making your EOB easier to understand. a health reimbursement arrangement which helps members pay for qualified medical expenses. 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. 0000007628 00000 n %PDF-1.7 % State Health Plan PPO - Administered by Blue Cross Blue Shield of Michigan (BCBSM). lo%x9d,oqM lzgw'TK6oB~+d; {qi.B/ R`]Hcq6~s_]=y&|9]Fl2b\o9Vp"(5Z9lb.dx;@? *Mii lkSW+0XI~'kT`C>?wlvR The account and money are yours. This plan didn't cover prescription charges, office visit charges, medical equipment, psychiatric services, or other major medical services. Try again later. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Access commonly requested forms for patient care activities, credentialing, and more. For Medicare Members: No-fault auto law changes Health (Just Now) WebThere are several ways you can request a QHC letter. They won't charge you the difference between their normal charge and the amount paid by the State Health Plan PPO. Physician Qualification Form (PDF) Healthy Blue Achieve Form Detroit, MI 48243. 1200 N. Telegraph Road Need new coverage? 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). Blue Cross Blue Shield of Michigan, in partnership with Lucet 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. Effective January 1, 2023, MSPTA-represented (To1) employees are eligible for this benefit, DROP employees and OEAIs and the dependents remain ineligible. You must be in pay status to receive this payment. We'll accept a qualification form from an office visit that occurred up to 180 days before the start of your plan year. You can also review your current plan to help make the best choice for 2021. Let's say Mary and her family have a normal year with normal doctor visits. 'TMjZ}dM`V;hO0 45o` T@> $0,Tkpp9~#@="-toen7=u-J 3P6sO1v 0IA||$IRs3R6o'j*vU#;B!FL5O,hBtA7|$xVv)*09KTOM8Gh6CAIT,[*6a8 wz 0000017849 00000 n 140 0 obj <> endobj An HSA is a smart way to save for your future qualified health expenses, including those that may come up in retirement. 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. Telemedicine Benefit Summary:Telemedicine visits allow you to meet with a US board-certified doctor online using a video-chat tool. 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. 0000016284 00000 n Mail Code 1112. [Narrator] Hello again, and welcome to Blue Cross Blue Shield of Michigan. 0000037572 00000 n 0000008045 00000 n And with the HSA Plus Plan, Ford will also contribute to your HSA. Behavior Health/Substance Use Disorder Administrator. You can keep your unlimited PIP coverage. 0000029515 00000 n Simply . 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. 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. startxref 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. First, let's look at the cost to have a medical plan. Members enrolled in the HSA plan will be responsible for paying an ER copayment after the deductible has been met. 0000035230 00000 n 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. Log in now myfordbenefits.com HELPS YOU: View personalized benefits Federal No Surprises Act: The federal government issued the "transparency in coverage" final rule under the Federal No Surprises Act. Questions About Your Benefits? 0000004148 00000 n 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. 0000015249 00000 n 0000045752 00000 n The state will make an annual HSA contribution of $750 for an eligible individual employee enrolled in the State HDHP or $1,500 for an eligible employee who enrolls with one or more eligible dependents in the State HDHP,* effective January 1. Michigan - Blue Cross and Blue Shield's Federal Employee Program Thank you for viewing. 0000000016 00000 n Enter the three letters of your "Enrollee ID" found on your Blue Cross Blue Shield member ID card, and then click Go. PIP coverage can include items like attendant care, housing modifications and lost wages. Your coverage is considered qualified if it: When making a decision, keep in mind that PIP has coverage that goes beyond traditional health insurance. %PDF-1.6 % And that both plans include a health savings account or HSA, that allows you to set aside tax-free funds that you can use for qualified medical expenses. Other costs to use the HSA Plan will vary depending on whether you select plan coverage for you or for your family. PDF Sample Qualified Health Coverage Documentation - Michigan 0000019432 00000 n bcbsm.com. 0 Government Human Resources Benefits Health Benefit Plans. You can use the money if you leave the company, change your plan, or retire. | _1S}9M{T=o9B^>.!a8Znpk9(6_ In our next scenario, James covers his wife on his medical plan. With the HSA Plan, you pay 100% of medical and prescription costs until your deductible is met. Before you select a medical plan, consider your total costs, including the costs to have and use the plan. State and Federal Privacy laws prohibit unauthorized access to Member's private information. 0000028187 00000 n State-sponsored health insurance carriers are prepared to send a letter to State employees or retirees, upon request, confirming their health plan is considered Qualified Health Coverage (QHC). %%EOF hbbd``b`$WX@]@D0(, IH0@1% b Cu@\v d"3|` 0000014702 00000 n Qualified Health Coverage & Michigan No-Fault Insurance 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. View the Telemedicine Benefit Summary to see your State-sponsored health insurance carrier's telemedicine coverage. What's qualified health coverage under the new law? 0000009647 00000 n Individuals attempting unauthorized access will be prosecuted. See your 2023 Benefits-at-a-Glance (PDF) for more plan details. 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. XYQ This product provides comprehensive PPO coverage with costsharing features. 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 93gpm},|P gaToY%+IzO96`%n'`Pll@BJa 0000036634 00000 n California Physicians Service DBA Blue Shield of California 1999-2023. In 2021, you'll have a choice between two HSA eligible medical plans, HSA Plan and HSA Plus Plan. 0000012102 00000 n Learnyour requirements, deadline dates and more about your coverage. 0000034485 00000 n Co-insurance is a percentage of the cost you share with the plan. For more information about the State of Michigan's eligibility requirements for employee health insurance coverage, . Current SHP PPO enrollees will be automatically transitioned with no gap or changes in coverage. 0000026320 00000 n 0000005625 00000 n Use the Find-a-Doctor tool to verify provider participation in one of our plan networks. SM. Select Claims on the menu bar. See below. Respond promptly to the carrier to complete the final phase of the enrollment process. With the total of all her family services and prescriptions, the HSA Plan costs $3,030 to use. Be informed about all your Blue Cross plan has to offer. You can call the number on the back of your member ID card. 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. 0000006930 00000 n If you choose to do so, you will be responsible for both deductibles. Field Service. You still have the freedom to go out-of-network to see any physician, hospital or other provider of your choice. 0000009279 00000 n No-fault auto insurance changes in Michigan | bcbsm.com 600 Lafayette East. Because Mary's cost to have the HSA Plan is $0, her total cost is $3,030. Health Insurance Coverage | Health Services | Michigan State University 1-313-225-9000. This plan provides health benefits using providers and facilities that are in-network, meaning the providers and facilities have agreed to accept a discounted fee from BCBSM in order to be in-network. If your auto insurance is requesting a QHC letter to issue or renew a policy, you may request a QHC letter by contacting your health carrier. }v".VrTAmk$NJ+ y{i-Y#gds7D 0000039800 00000 n .r~'J ms-oA&@i 9k2 J4T{Yt;cu6J_Fs"6r|(Z? {07 N_Bdk 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. 0000060102 00000 n 0000048976 00000 n 0000023020 00000 n An HDHP offers a lower biweekly premium in exchange for higher deductibles and out-of-pocket limits. Michigan Qualified Health Insurance Letter #G:&#WeKo]b287X]4 fd!n>X3jG[)GW%0.{1,JqA]Vf,fyf#Ji+OvDUpe!K|\"e2{g3ePW?/p
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bcbsm qualified health coverage letter