If you are taking or prescribed a drug that is not on your plan's Drug List, call the number on your member ID card to see if the drug may be covered by your medical plan. Examples of these drugs are contraceptive implants and chemo infusion. These drugs are often given to you in a hospital, doctor's office or health care setting. These can include drugs that must be given to you by a health care provider. Some drugs are covered under your medical plan instead of your pharmacy benefits.
Health plans may administer medical and pharmacy coverage separately for select drugs. Based on your benefits, if you use a drug manufacturer’s coupon or copay card to pay for a covered prescription drug, this amount may not apply to your plan deductible or out-of-pocket maximum. This may help lower your out-of-pocket costs. Your doctor should consult the Drug List when prescribing drugs for you. These prescription drug lists have different levels of coverage, which are called "tiers." Generally, how much you pay out of pocket for a prescription drug will be less if you choose a drug that is a lower tier. How much you pay out-of-pocket for prescription drugs is determined by whether your medication is on the list. If any inconsistency exists between this site and the written plans or contracts, the actual provisions of each benefit plan will govern.A drug list is a list of drugs available to Blue Cross and Blue Shield of Texas (BCBSTX) members. However, if any provision on the benefits plans is unclear or ambiguous, the Benefits Office reserves the right to interpret the plan and resolve the problem. Every effort has been made to ensure the accuracy of the benefits information in this site. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend, or terminate them. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. The University of Michigan in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. If you are eligible, you may want to consider enrolling in a pre-tax health care Flexible Spending Account (FSA) to complement your health plan.Ĭall the SSC Contact Center at 5-2000 from the Ann Arbor campus, (734) 615-2000 locally, or (866) 647-7657 toll free, Monday through Friday from 8 a.m. Group number: 007005187 Consider a Health Care Flexible Spending Account Member Handbook MNA (for members of the Michigan Nurses Association). Search here to locate a participating PPO provider or find out if your doctor accepts this plan. 
To obtain in-network benefits while out of the U.S., check for participating providers at. The BCBSM Community Blue PPO is the only plan offering this enhanced level of coverage. Plan members can refer themselves to doctors of their choice, including specialists, inside and outside the network however, higher out-of-pocket costs are incurred for using out-of-network providers.Ĭommunity Blue PPO members are covered at the in-network benefit level when receiving care for approved services while outside the U.S., where no network is available.
The Community Blue PPO plan offers limited out-of-pocket costs, and access to healthcare providers throughout the U.S. $5,000 individual/$10,000 family out-of-pocket maximumįor complete information on benefits and coverage, please refer to the plan documents.Mental health, behavioral health or substance abuse services.$3,000 individual/$6,000 family out-of-pocket maximum.No out-of-pocket cost to you for outpatient surgery.No out-of-pocket cost to you for inpatient services.$25 copay for mental health, behavioral health or substance abuse services.$100 copay for emergency care (waived if admitted).$25 copay for office visit for injury or illness.No out-of-pocket cost to you for preventive care.The plan is administered by Blue Cross Blue Shield of Michigan (BCBSM). without a referral, with lower out-of-pocket costs when you use in-network providers. The Community Blue PPO plan offers members the flexibility to see any provider throughout the U.S.
0 kommentar(er)
