For example: a single person chooses an in-network hospital for surgery. Find specialists for referrals with our online tool that lets you search by doctor's name, location, specialty and more. The Community Blue PPO plan offers members the flexibility to see any provider throughout the U.S. without a referral, with lower out-of-pocket costs when you use in-network providers. This is the lowest copay tier for prescription drugs. Individuals attempting unauthorized access will be prosecuted. Get access to your provider portal.Register Now, Not registered? Your email address and phone number may be used to contact you. Important Legal and Privacy Information|Important Information About MedicarePlans|Privacy Practices|Site Map|Feedback|Download Adobe Acrobat Reader, Y0074_BCBSMBCNWeb_M_2023_C CMS Accepted 04232023, Page Last Updated Mon Jan 09 16:13:00 EST 2023. When this pharmacy directory refers . Register Now, Learn more about registering for our web tools. Report doctor information error. Read about the latest news and innovations from the experts themselves. PCP Focus is a custom primary care physician HMO network offered by Blue Care Network. Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader, Important Information About MedicarePlans. Community Blue Platinum $0 Community Blue Platinum $250 Community Blue Platinum $500 Community Blue Gold $1000 HRA plans Community Blue HRA Platinum $1500 ($1250) Community Blue HRA Gold $3000 ($750) Community Blue HRA Gold $5000 ($1500) This is where you'll find fast answers to your most common questions about being a Blue Cross provider. If you have a technical question about this website, please call Get access to your employer portal.Register Now, Not registered? We provide health insurance in Michigan. Refer to this list for drug coverage information for Blue Cross members whose plan uses the Custom Drug List. We provide health insurance in Michigan. Register Now, Not registered? These service providers will be bound by sufficient guarantees to implement appropriate technical and organizational measures in such a matter that their processing will meet the requirements of applicable law. If you are not satisfied with our data processing you have the right to lodge a complaint to the data protection authority in your country of residence. The Plan also covers most of your community-based care (office visits), as well as necessary medical equipment and supplies (crutches, hearing aids, etc.). The State Health Plan PPO provides reimbursement for medical care expenses when you need treatment for an illness, injury, or disease. Be a part of the largest network in the state, with fast access to everything you need to check benefits and submit claims. This is a mid-level plan with a $3,000 deductible. Have Questions? Effective October 1, 2019, Blue Cross Blue Shield of Michigan, in partnership with New Directions, will be replacing Magellan Health as the State Health Plan (SHP) PPO Behavioral Health/Substance Abuse carrier. Have your I.D. This drug list is updated monthly. Join a live presentation with our health care experts, examining topics you've told us mean the most to your business. This lists the enhanced comprehensive drugs we cover for Medicare Plus Blue Group and Prescription Blue Group PDP plans. Our agents can help you set up your plan, enroll your employees and help you determine the easiest way to set up payments. Search for the highest-quality providers using the Blue Distinction. Refer to this list for drug coverage information for Blue Cross members whose plan uses the Clinical Drug List. Heres how you can travel confidently with your Medicare Advantage or Medicare Supplement plan. This is a mid-level plan with a $500 deductible. They offer: We can help you decide which is best for your business and employees. This list is updated monthly to keep you informed of changes. Get access to your employer portal. An important note regarding the State Health Plan PPO deductibles: You have the freedom to see both in-network and out-of-network providers. card and plan name handy to assist with the process. Insurance List | Carriers Currently Filed by Labcorp Your employees will get the tools, information and support they need all under one secure online account. . Refer to this list for the drugs and products covered by Blue Cross and BCN at no out-of-pocket cost to members and comply with health care reforms preventive benefits requirements. If you have questions about Medicare Plus Blue PPO, please call our Customer Service department at 1-877-241-2583, 8:00 a.m. to 9:00 p.m., Monday through Friday. Your Personal Data will remain on file for: any period required by applicable law; and, to the extent necessary for any purpose(s) provided directly or indirectly herein or as may be reasonably inferred from the content contained in this notice or the website, but no longer than permitted by applicable law. Get access to your agent portal.Register Now. Find eye care Use the link to register for your account and find an eye care professional. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. Always ask the doctor if they accept your Medicare Advantage plan before making an appointment. AZBlue - Find a Doctor in Arizona - BCBSAZ State Health Plan PPO Behavioral Health/Substance Abuse Frequently Asked Questions, State Health Plan Preferred Provider Organization (PPO), OptumRx is the Pharmacy Benefit Manager for the State Health Plan PPOand will administer all retail, mail-order, and specialty, Go to Qualified Transportation Fringe Benefits (QTFB), Active Employee State Health Plan PPO BCBSM Plan Booklet, Retiree State Health Plan PPO With Medicare Booklet, State Health Plan PPO Behavioral Health/Substance Abuse Frequently Asked Questions. For Providers: Drug lists | BCBSM This represents the most youll have to pay during a policy period, usually a year, for health care services. Plan highlights High-quality benefits your employees will want with the lowest out-of-pocket costs available Get access to your agent portal.Register Now. They areresponsible for the deductible, then the hospital is reimbursed according to the plan design. What do I need for my first trip to the pharmacy as a Medicare customer? Log in to our provider portal (availity.com*). 24/7 online access to account transactions and other useful resources, help to ensure that your account information is available to you any time of the day or night. This drug list is updated monthly. Helpful information for providing and billing for Medicare services in the Blue Cross network. Get access to your provider portal. Refer to this list for drug coverage information for BCN members with a 3 or 5-Tier benefit whose plan uses the Custom Drug List. This is a standard-level plan with a $4,000 deductible. It makes up part of the out-of-pocket maximum. State Health Plan PPO - Administered by Blue Cross Blue Shield of Michigan (BCBSM). How do I choose an HSA, FSA or HRA for my employees? Let us help you choose the plans that meet your strategic goals. All our Community Blue PPO plans use the Custom Select Drug List (PDF). Labcorp will file claims for insured patients directly to Medicare, Medicaid, and many insurance companies and managed care plans. More information about our provider and pharmacy directory Small Group Employers: Community Blue PPO | bcbsm.com This document spells out our quantity limits for certain drugs, like opioids. The web Browser you are currently using is unsupported, and some features of this site may not work as intended. Browse brochures, videos and posters designed to help your employees get the most out of their Blue Cross coverage. Read more about the types of doctors and specialists We provide health insurance in Michigan. This drug list is updated monthly. We provide health insurance in Michigan. This drug list is updated monthly. Get access to your online account. Contact an agent to learn more. Register Now, Not registered? The embedded coinsurance maximum is the most youll have to pay in coinsurance during a policy period. The plan covers inpatient hospital care, as well as other outpatient services received at a hospital including emergency room care. State and Federal Privacy laws prohibit unauthorized access to Member's private information. This lists the standard enhanced comprehensive drugs we cover for Medicare Plus Blue Group and Prescription Blue Group PDP plans. Small Group Employers: Simply Blue PPO | bcbsm.com Get to know your options, from in-person checkups to online health care. Your Personal Data will be disclosed to appropriate personnel for purposes of performing services to, or on behalf of, our enterprise customers and prospective customers as part of and in relation to matters regarding our provider, health plan, and subsidiary enterprise care delivery, administration and operations. After that, all Personal Data will be deleted or the documents with such data will be anonymized. The State Health Plan PPO provides reimbursement for medical care expenses when you need treatment for an illness, injury, or disease. This document explains coverage criteria for certain drugs. Find specific information about your plan or you can find a pharmacy that accepts your plan. For members with a closed benefit design, nonpreferred drugs aren't covered unless we authorize them as medically necessary. This is where you'll find fast answers to your most common questions about being a Blue Cross provider. This drug list is updated monthly. But, if you receive services from a provider not in the PPO network, you may be responsible for paying additional out-of-pocket costs. Who has a health plan through my employer, But might get a BCBSAZ health plan through my employer, And want to review my information or refer a patient. AZBlue - Healthcare Professionals: Information, Forms, and other Blue Cross commercial provider resources You can find additional information about Blue Cross provider resources in the Blue Pages Directory chapter of the Blue Cross Commercial Provider Manual. Behavior Health/Substance Abuse Administrator. Register Now, Not registered? 2. The doctors your employees will choose from this network have shown they can provide quality care and a high level of efficiency that lowers health care costs. You start paying coinsurance once youve met your plans deductible. You can reach us at 1-855-237-3501, or talk to a Blue Cross-authorized, independent agent. View cost estimates* for services, so you can compare and potentially save. When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. 3 . Register for MyBlue. Get to know your options, from in-person checkups to online health care. This is a top-level plan with a $250 deductible. 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. These plans are designed to provide comprehensive benefits with the freedom of a traditional PPO. They won't charge you the difference between their normal charge and the amount paid by the State Health Plan PPO. Call 877-258-3932 | Privacy Policy 1996-Blue Cross Blue Shield of Michigan and Blue Care Network Nonprofit corporations and independent licensees . We will retain the information in our system in accordance with applicable law and our Data Protection Policy:https://www.highmark.com/hmk2/gdpr.shtml. This list is for small group or individual health plans that began on or after Jan. 1, 2014 and meet the requirements of the Patient Protection and Affordable Care Act. Add or remove Provider Secured Services users, or change access for existing users.