MIIA - Blue Cross Blue Shield Proposed Benefits. Plan Offerings HMO Blue New England (HMO) Blue Care...

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MIIA - Blue Cross Blue Shield Proposed Benefits

Transcript of MIIA - Blue Cross Blue Shield Proposed Benefits. Plan Offerings HMO Blue New England (HMO) Blue Care...

Page 1: MIIA - Blue Cross Blue Shield Proposed Benefits. Plan Offerings HMO Blue New England (HMO) Blue Care Elect Preferred (PPO)

MIIA - Blue Cross Blue Shield Proposed Benefits

Page 2: MIIA - Blue Cross Blue Shield Proposed Benefits. Plan Offerings HMO Blue New England (HMO) Blue Care Elect Preferred (PPO)

Plan Offerings

• HMO Blue New England (HMO)

• Blue Care Elect Preferred (PPO)

Page 3: MIIA - Blue Cross Blue Shield Proposed Benefits. Plan Offerings HMO Blue New England (HMO) Blue Care Elect Preferred (PPO)

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HMO Blue New England HMO

Blue

Use HMO Blue Network Providers PCP Required – Change Anytime Referrals To Network Specialists No Referrals For: OB/GYN Care, Chiropractic

Care, Outpatient Behavioral Health Visits, Routine Vision Exam, Emergency Or Out-Of-Area Urgent Care

Page 4: MIIA - Blue Cross Blue Shield Proposed Benefits. Plan Offerings HMO Blue New England (HMO) Blue Care Elect Preferred (PPO)

Blue Care Elect Preferred (PPO)

• No Primary Care Physician Needed

• No Referrals Needed For Specialty Care

• National Network – Ability to have services rendered out of state at the same out of pocket cost as HMO members

Page 5: MIIA - Blue Cross Blue Shield Proposed Benefits. Plan Offerings HMO Blue New England (HMO) Blue Care Elect Preferred (PPO)

Find A Blue Cross Network Provider

Visit www.bluecrossma.com Call Physician Selection Service 1-800-821-

1388 Ask Your Providers If They Are In The HMO

Blue Network

Page 6: MIIA - Blue Cross Blue Shield Proposed Benefits. Plan Offerings HMO Blue New England (HMO) Blue Care Elect Preferred (PPO)

Proposed Changes

• Addition of a plan year deductible for some services - $250 Per Individual, $750 Per Family

• Primary Care Physician Office Visits

• Specialist Office Visits

• Emergency Room Visits

• MRI, CT and PET Scans

• Prescription Drugs

Page 7: MIIA - Blue Cross Blue Shield Proposed Benefits. Plan Offerings HMO Blue New England (HMO) Blue Care Elect Preferred (PPO)

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Services That Are Not Subject

to the Deductible

SERVICES THAT ARE NOT SUBJECT TO DEDUCTIBLE

Preventive Visits, Related Tests & Immunizations: You Pay $0 (no change)

Diagnostic PCP, OB/GYN, Nurse Practitioner Visits: You Pay $20 (today you pay $10 to $20 per visit)

Mental Health Office Visits You Pay $15 (today you pay $10)

Other Professional Providers & Specialist Visits: You Pay $35. (today you pay $25)

Prescription Drugs You Pay 10/25/50 for a 30 day supply, 20/50/110 through Mail Service. (today you have a 10/20/40 for retail, 20/40/90 mail.)

Chiropractic Visits – You pay $20 (today you pay $15)

Short Term Rehabilitation Therapy – You Pay $20 (today you pay $15)

Speech, hearing, and language disorder treatment – You Pay $20 (today you pay $15)

Page 8: MIIA - Blue Cross Blue Shield Proposed Benefits. Plan Offerings HMO Blue New England (HMO) Blue Care Elect Preferred (PPO)

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Services Subject To The

DeductibleAfter You Pay $250/$750. Plan Year Deductible, Then: Diagnostic Labs, X-Rays & Other Tests: You Pay $0 (today you have no

deductible) CT, Pet Scans and MRI - $100 per category of tests ( today you pay $0

with no deductible) Emergency Room: You Pay $100 (today you pay $100 with no

deductible). Inpatient Admissions: You Pay $300 at a lower cost hospital, $700 at a

higher cost hospital. (today you pay $200 for Lower cost hospitals and $400 for higher cost hospital with no deductible)

Surgical Day Care – You Pay $150 per admission after deductible (today you pay $150 and have no deductible)

Hospice and Home Health Care - $0 after deductible (today you pay nothing with no deductible)

Durable Medical Equipment You Pay $0 after Deductible (today you pay $0 with no deductible)

Prosthetic Devices – You pay Nothing after deductible – (today you pay 20% co-insurance)

Page 9: MIIA - Blue Cross Blue Shield Proposed Benefits. Plan Offerings HMO Blue New England (HMO) Blue Care Elect Preferred (PPO)

Why Change?

• Benefits will not change for a period agreed upon by management and labor)

• No hidden out of pocket costs

• No off anniversary rates increases

• Deductible is plan year not calendar year

Page 10: MIIA - Blue Cross Blue Shield Proposed Benefits. Plan Offerings HMO Blue New England (HMO) Blue Care Elect Preferred (PPO)

Out-Of-Pocket Maximum

Current Plan:

$600 Enhanced Tier admission out of pocket maximum

$1200 out of pocket maximum for Standard or basic tier admission

$300. out of pocket maximum for Surgical Day Care Admissions.

New Plan:

$1200 out of pocket maximum for all inpatient admissions

$600 out of pocket maximum for surgical day care admissions

Page 11: MIIA - Blue Cross Blue Shield Proposed Benefits. Plan Offerings HMO Blue New England (HMO) Blue Care Elect Preferred (PPO)

Healthy Living

$150 Fitness Benefit $150 Weight Loss Benefit Childbirth Class Benefit Living Healthy Babies Blue Care Line: 1-888-247-BLUE (2583) Living Healthy Vision Discounts Living Healthy Naturally Discounts Safe Beginnings Discounts

Page 12: MIIA - Blue Cross Blue Shield Proposed Benefits. Plan Offerings HMO Blue New England (HMO) Blue Care Elect Preferred (PPO)

Member Central Account

Visit www.bluecrossma.com

Create An Online Account, Then You Can: Change Your PCP Request An ID Card Review Your Plan Benefits Review Your Claims Track Your Deductible & Coinsurance Enroll In My Blue Health

Page 13: MIIA - Blue Cross Blue Shield Proposed Benefits. Plan Offerings HMO Blue New England (HMO) Blue Care Elect Preferred (PPO)

Questions?

For Provider Information Or Questions

On Your Membership, Benefits, Referrals Or Claims

Call Member Service Toll-free Number On ID Card

Monday - Friday, 8 a.m. - 6 p.m.

Or Visit www.bluecrossma.com