0000026320 00000 n 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. Contact your auto insurance agent with questions and to learn more about your options. 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. When we look again at the total cost of having and using the plans, the HSA Plan is the lower cost option for John. Qualified Healthcare Coverage Letter 0000010017 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 Look for the chat icon at the bottom right corner of the screenon any page of this website. It has more than 20,000 physicians, including specialists, and more than 140 all acute care hospitals in Michigan. 0000051836 00000 n hb``a`` -mY8PE!u[dCC#W6,j.Fvtl,s fb`p;CT3j 93gpm},|P gaToY%+IzO96`%n'`Pll@BJa After that deductible is met, out-of-network charges are paid according to the plan design. The HSA balance belongs to the employee and can be carried over from year to year. 0000008674 00000 n Ready to enroll? 0000017188 00000 n You can also take a closer look at your current plan to help you make the best choice for your 2021 plan. 0000012102 00000 n Qualified Transportation Fringe Benefits (QTFB). Your Benefit Guide State Health Plan PPO 3 Visit BCBSM Customer Service Center 232 S. Capitol Ave. Lansing, MI 48933 . Find information about Promise Medi-Cal and Cal MediConnect, our policies, procedures and programs. Members enrolled in the HSA plan will be responsible for paying an ER copayment after the deductible has been met. PDF Frequently asked questions for customers about Public Acts 21 and 22 K4[WYV5pL@=>QBuD Once logged in, navigate to the QHC letter in the Proof of Insurance section at the bottom of the page. Please see below for further information. 0000022361 00000 n 0000024839 00000 n SM. a health reimbursement arrangement which helps members pay for qualified medical expenses. 0000047030 00000 n | _1S}9M{T=o9B^>.!a8Znpk9(6_ General Inquiries. 0 *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). PDF State of Michigan }v".VrTAmk$NJ+ y{i-Y#gds7D 0000024311 00000 n Qualification Forms | Managing My Account | bcbsm.com For auto insurance policies issued or renewed after July 1, 2020, Michigan's Automobile No-Fault Insurance Law will change. 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. &yw}.$7eIw <<674A7177E0417F4590EC384E93D00AED>]>> 0000036634 00000 n 0000025213 00000 n If your no-fault insurance carrier requests or requires confirmation of your university health plan's position for coordination with no fault, please call the SSC Contact Center at 734-615-2000 or 1-866-647-7657 (toll free). You don't need to wait until your new plan year starts to see your doctor. You may enroll in an authorized HMO plan serving your residential area. em4MVRpH ~*.V%s^5h}R,uJXP;6s@bH{{J 4aWS8r *W~oKMwSV-Kl^voIb #TY^hAP38HUR{mv8azF`lAQm8yiKm77!}1nW 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. Healthcare includes your Medical (ASR, BCBS, or HAP), Prescription (Navitus or HAP), Dental (Delta Dental), and Vision (NVA). Access commonly requested forms for patient care activities, credentialing, and more. 0000048976 00000 n 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. 0000043394 00000 n %PDF-1.7 % 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. 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. Log in now myfordbenefits.com HELPS YOU: View personalized benefits Blue Care Network Qualification Form - BCBSM An HSA is a smart way to save for your future qualified health expenses, including those that may come up in retirement. 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. Both plans include a health savings account HSA. Effective January 1, 2023, MSPTA-represented (To1) employees are eligible for this benefit, DROP employees and OEAIs and the dependents remain ineligible. 0000006680 00000 n 13 0 obj <> endobj %%EOF 0000009647 00000 n Please provide the following information about the policy holder of the other health coverage. 0000020133 00000 n For Medicare Members: No-fault auto law changes bcbsm.com Health (Just Now) WebThere are several ways you can request a QHC letter. 0000006930 00000 n You can also opt-out if you qualify for that provision. lC]n8\! The web Browser you are currently using is unsupported, and some features of this site may not work as intended. Individuals attempting unauthorized access will be prosecuted. 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. The network covers all 83 Michigan counties and is the largest PPO network in Michigan. 0000049165 00000 n 0000027006 00000 n *Blue Shield of California member plans only, Pre-service review for out-of-area members. He paid the full $800 cost of his medical services because the cost is less than the deductible for either plan. 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. This plan covered inpatient hospital expenses, as well as certain other services received at the hospital on an outpatient basis (including emergency room care). An HDHP offers a lower biweekly premium in exchange for higher deductibles and out-of-pocket limits. 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. Detroit, MI 48243. Medicare | Claim Forms | bcbsm.com John's annual paycheck deduction for the HSA Plan is zero. 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. 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). Let's start with Mary who selected a plan to cover her family. Coordination of Benefits Questionnaire - BCBSM PDF Sample Qualified Health Coverage Documentation - Michigan Callers to our phone lines are currently experiencing long wait times. Click My Plan and Spending. We appreciate your understanding. 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. 0000048613 00000 n 140 0 obj <> endobj You can choose your own primary care physician who will provide direct care or make referrals from within the network. Learn about our tools and how to use them in our upcoming webinars. 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. Medical Insurance - Lansing Community College Please review directory information to ensure its accuracy before attesting. To file a Blue Cross Blue Shield Global Core eClaim online, log in with your username and password or register for access. Or, call the number on the back of your member ID card. 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=. 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. All rights reserved. 0000032096 00000 n 0000027473 00000 n 0000009279 00000 n You keep what you dont spend on medical expenses, even if you retire or leave state employment. 0 0000007848 00000 n Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. Michigan Auto Insurance Reform -- What HAP Members Should Know State and Federal Privacy laws prohibit unauthorized access to Member's private information. 0000011869 00000 n Learn more about your Blue Cross Blue Shield of Michigan plan options. 0000058981 00000 n Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. Contact your auto insurance carrier for specific questions regarding PIP coverage. NO - YES - Please complete entire form, sign at the bottom and return sign at the bottom and return . endstream endobj startxref 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. "Qualified Health Coverage" means your health coverage: Does not exclude or limit coverage for motor vehicle accidents; and Has an annual deductible of $6,000.00 or less per covered individual. hbbd``b`$WX@]@D0(, IH0@1% b Cu@\v d"3|` 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. You can log in to your online member account to see if you have a QHC letter to download. For the HSA Plan, your deductible and out-of-pocket maximum amounts for in-network services are the same. We're making your EOB easier to understand. startxref 0000021168 00000 n Pontiac, MI 48341. xref 0000005259 00000 n To request your QHC confirmation letter: Log in to your member account. California Physicians Service DBA Blue Shield of California 1999-2023. b|=b}#Aif3TRD0;@NHkQ#`VEQxD 0000017479 00000 n For Medicare Members: No-fault auto law changes Health (Just Now) WebThere are several ways you can request a QHC letter. We can help. The maximum deductible for two or more covered persons in your family was limited to 1 months of your basic salary. 0000029999 00000 n 0000026660 00000 n 0000014332 00000 n Federal No Surprises Act: The federal government issued the "transparency in coverage" final rule under the Federal No Surprises Act. 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. Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. 163 0 obj <>stream XYQ This product provides comprehensive PPO coverage with costsharing features. 120 0 obj 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. PIP coverage can include items like attendant care, housing modifications and lost wages. 0000018397 00000 n (5 days ago) WebTo request a proof of qualified health coverage letter, contact Blue Cross' Customer Service department at 1-800-422-9146 from 8:30 a.m. to 5 p.m. Eastern time, Monday https://hwnr.bcbsm.com/content/dam/microsites/mpsers/2020/best-of-health-summer-nonmedicare.pdf Category: Health Show Health Filter Type: Treatment This tool provides side-by-side medical plan comparisons and personalized cost modeling. 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. The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. Your explanation of benefits (EOB) statement has a new look. endstream Provided in a vehicle qualified as an ambulance and part of a licensed ambulance operation Michigan Auto Insurance & Coordination of Benefits Explained The HSA Plan is available to you at no cost. 0000022070 00000 n 248-524-0454 0000048755 00000 n 0000060102 00000 n <>/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 0000020507 00000 n If you absolutely need to call, please try again at a later date. Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader, Important Information About MedicarePlans. MSU Student Health Insurance Plan. 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. These scenarios are simple, and there are many other ways you can consider managing your out-of-pocket costs with your health savings account. 0000049042 00000 n The document must: An HMO is a managed care plan that provides medical care through its network of physicians, pharmacies, contracted hospitals, and medical care suppliers. Take a look at what Blue Cross plans offer, then choose the one that's right for you. Now let's look at what a single person with relatively few healthcare needs might experience. 0000019721 00000 n 0000060222 00000 n Government Human Resources Benefits Health Benefit Plans. 258 0 obj <> endobj Letters for your auto insurance carrier - MESSA To help your savings grow even more, when your HSA balance reaches $1,000, you can choose a variety of investments. Thank you for viewing. 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. 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. hm6?ZqJ!nv+E 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. Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health 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. 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. Need a Health Care Plan Verification Letter for Your Auto Insurance For the HSA Plus Plan, Ford contributes $1,000 towards Mary's health savings account, which further reduces her cost to use this plan. 0000003914 00000 n No-fault auto insurance changes in Michigan bcbsm.com Health (6 days ago) WebThere are several ways you can request a QHC letter. h1aMXk* Q)DDJjH$*F 0000012767 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 This contribution will be prorated for employees who enroll mid-year. The Plan also covers most of your community-based care (office visits), as well as necessary medical equipment and supplies (crutches, hearing aids, etc.). 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. 0000013667 00000 n 0000034485 00000 n \8/$z New SHP PPO membership ID cards will be mailed in September 2019. If your spouse's (non-State) employer will not cover you under their group plan because you are enrolled in any of the State-sponsored health care options,you can "opt out" completely and still receive the $50 biweekly payment (select "Health Waiver with Rebate"). Because Mary's cost to have the HSA Plan is $0, her total cost is $3,030. You can call the number on the back of your member ID card. In 2021, you'll have a choice between two HSA eligible medical plans, HSA Plan and HSA Plus Plan. 0000018771 00000 n View detailed plan information in this document. bcbsm.com. 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). Michigan - Blue Cross and Blue Shield's Federal Employee Program 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. $"mY_%Be66y=\"QI 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. Simply . You have certain tasks to complete within specific . Available for commercial, Shared Advantage, and BlueCard. James has arthritis, so he needs to take a higher cost maintenance drug. Under the plan documents section, click Michigan Auto Reform to request a letter be mailed to the subscriber's address. 0000010919 00000 n First, let's look at the cost to have a medical plan. For more information about the State of Michigan's eligibility requirements for employee health insurance coverage, . 0000034422 00000 n When an out-of-area Blue plan member seeks medical care from your office, use our tools to simplify claims submission to BlueShield of California. 0000042215 00000 n %PDF-1.6 % hb```5,|z cbD{600T|txGyG{T8"W3\baah4p1$$ v3Kx4@6@ 1 0000027161 00000 n Your email address will not be published. What to Know About Changes to Michigan's Car Insurance Law They won't charge you the difference between their normal charge and the amount paid by the State Health Plan PPO. 0000028187 00000 n 0000014991 00000 n Be informed about all your Blue Cross plan has to offer. 0000004937 00000 n See your 2023 Benefits-at-a-Glance (PDF) for more plan details. Log in to continue with member verification. 0000021696 00000 n Click continue to proceed with verification. 0000030483 00000 n 0000011580 00000 n Learnyour requirements, deadline dates and more about your coverage. For more info, visitwww.mi.gov/AutoInsurance, emailAutoInsurance@mi.gov, or call 833-ASK-DIFS (275-3437). Health Plan Details 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. 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. The out-of-pocket maximum does not include monthly paycheck contributions, copayments, or any expenses not covered by your plan. 577 0 obj <>stream 0000036168 00000 n View the Telemedicine Benefit Summary to see your State-sponsored health insurance carrier's telemedicine coverage. 0000025504 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. Telemedicine Benefit Summary:Telemedicine visits allow you to meet with a US board-certified doctor online using a video-chat tool. 0000028854 00000 n 0000023650 00000 n Go paperless by submitting claims and managing payments online for free. You can now file disputes, attach supporting documents, and retrieve letters for submitted disputes online! 0 0000031798 00000 n Your coverage is considered qualified if it: When making a decision, keep in mind that PIP has coverage that goes beyond traditional health insurance. 0000005858 00000 n .r~'J ms-oA&@i 9k2 J4T{Yt;cu6J_Fs"6r|(Z? Detroit, MI 48226-9942. 1tv Those costs include increased copay and deductible amounts. *Note: MSPTA-represented (T01) employees, DROP employees, and Other Eligible Adult Individuals (OEAIs) and their dependents are not eligible for this benefit. %%EOF Members should direct specific questions about PIP coverage to their auto insurer. 0000013137 00000 n 600 Lafayette East. You can log in to your online member account to see if you have a QHC letter to download. 0000026478 00000 n 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. In the HSA Plus Plan, you're also responsible for all medical and prescription costs until your deductible is met. PPO. This plan didn't cover prescription charges, office visit charges, medical equipment, psychiatric services, or other major medical services. 0000007628 00000 n 0000015623 00000 n After the deductible and coinsurance are applied for the HSA Plus Plan, James will be responsible for $3,480. 193 0 obj <>stream Questions About Your Benefits? #G:&#WeKo]b287X]4 fd!n>X3jG[)GW%0.{1,JqA]Vf,fyf#Ji+OvDUpe!K|\"e2{g3ePW?/p Log in to get your questions answered by a live representative, Monday through Friday, 6 a.m. to 6:30 p.m. Plan: Blue Care Network (BCN) Premium Cost: Summer 5/16/20 - 8/15/20 $474.00 (approx. 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. SECTION 2 OTHER HEALTH COVERAGE INFORMATION . Your doctor will submit the form by following the instructions on the back. PDF Blue Cross Blue Shield of Michigan: Understanding member ID cards PIP is the part of an auto insurance plan that covers the health care costs from a car . 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. <> Ford offers an accelerated contribution option. 0000004148 00000 n 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. Later in the year, that same person needs an MRI and chooses an out-of-network provider. Select Claims on the menu bar. GradCare Member Reimbursement Form U-M Premier Care Member Reimbursement Form 0000029515 00000 n Thank you for viewing. Demographics |Electronic Data Interchange (EDI) | Recoveries, Need help with Provider Connection: Blue Shield Provider Connection Guide Provider Connection training. 0000037572 00000 n For Ford Employees: 2023 Health Plans | BCBSM 0000059211 00000 n You're now aware you have a choice between two HSA eligible medical plans in 2021. 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 . Create an account now. Claims | Benefits | Member eligibility | How to use Provider Connection | Contracts | Credentialing | %PDF-1.7 % Two letters confirming you have MESSA coverage that are often requested by your auto insurance carrier can be found in your MyMESSA member account.
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bcbsm qualified health coverage letter