270 likes | 485 Views
Open Enrollment. Health Care Coverage For You and Your Family A&M Care Plans. Welcome. What’s new for 9/1/2010 plan Year. 30 day limit for in-patient Mental Health dropped 40 visit limit for out-patient office visit dropped Mental Health office visit copay decreases to $30.00
E N D
Open Enrollment Health Care CoverageFor YouandYour Family A&M Care Plans Welcome
What’s new for 9/1/2010 plan Year • 30 day limit for in-patient Mental Health dropped • 40 visit limit for out-patient office visit dropped • Mental Health office visit copay decreases to $30.00 • Complete a Health Risk Assessment and/or Annual Physical to receive a $50.00 credit towards your deductible • Primary Care Physicians office visit copay increases to $30.00 • Reminder: Colon Cancer Preventive Screening and Mamogram covered at 100% after office visit copay
Why Blue Cross and Blue Shield? Blue Cross and Blue Shield is one of the mosttrustedbrands, recognized as a symbol of security and quality 97 million Americans (1 in 3) are covered by Blue Cross and Blue Shield • Scott & White providers and facilitieshave been added to the Blue Choice Network • Blue Extras - Discount programs • TheTexas A&MSystem dedicatedcustomer serviceunit • Provider Finder • Out-of-state providers
PPO Features A&M Care 350 and 1250 Plans • Administered by Blue Cross and Blue Shield of Texas • No primary care physician (PCP) required; no referrals required to see a specialist • Select any provider for care within the PPO network or outside the network • When you receive care inside the network • Highest level of benefits • No claims to file • No balance billing • When you receive care outside the network • May have to file own claims • Can be balance billed • Worldwide coverage for emergency andnon-emergency care
RETIREE INFORMATION For Retirees Under Age 65: • Considered Network • Network providers • Choose between the 350 plan and the 1250 plan
Retirees Age 65 and Over Choose from three plans • A&M Care 350 • A&M Care 1250 • 65 Plus • Age 65 and enrolled in Medicare Parts A&B or disabled under 65 and enrolled in Medicare Parts A&B • You & your covered spouse are both age 65 and older (or disabled) and enrolled in Medicare Parts A&B • If you are working for the A&M system, you are working six months or less in the plan year
IMPORTANT REMINDERSfor retirees • Enroll in BOTH Medicare parts A & B. • When you receive your Medicare Card notify BCBSTX of your Medicare number which includes an alpha character • If you use a Provider that takes Medicare or a BCBSTX provider you cannot be balance billed.
For World Wide Assistance Call 1-800-810-BLUE (2583) Or Collect 1-804-673-1177 In-network coverage is available when traveling or living worldwide 24 Hours a Day, Seven Days a Week Available More Hospitals and Doctors For a current listing of all providers see our website at: www.bcbstx.com Offers names, addresses, andmap directions.
Personal Health Manager Member Account Management Resources Health Risk Assessment Member Care Profile Blue PointsSM Incentives Blue Access®for Members www.bcbstx.com/members BlueExtrasSM Discounts Treatment Cost AdvisorTM Hospital Comparison Tool Blue Access®for Members Experience. Wellness. Online. *Depending on coverage type
Blue Access®for Membersbcbstx.com Links to My Health features and the Personal Health Manager Read the latest news & updates Review benefit coverage Review secure messages Use Quick Links to request replacement ID cards, download forms and more Update user profile settings View the most recent medical claims Download Blue Access® icon to your desktop for quicker access
Personal Health ManagerHome Page Read secure messages Take a Health Risk Assessment Access MemberCare Profile Review member alerts Ask a Question to a certified Nurse, Trainer, Dietitian or Life Coach Use the Interactive Symptom Checker Read the latest health news, search for specific health topics or explore the prescription drug index Explore topics in the Health Information and Care Center
Health Risk Assessment Powerful Health and Wellness Tool www.bcbstx.com • Interactive and user-friendly health assessment tool • Personal Health Risk Assessment Designed to Be Completed in 10 to 15 minutes • Choose your assessment topic such as health and Wellbeing or fitness and physical activity Know Your RisksManage Your Health Examines the members overall health and wellbeing and provides a Personalized report that highlights areas where you can improve Complete the HRA and/or Annual Physical and receive a $50.00 deductible Credit
Blue PointsSM Incentives Stay motivated. Earn Blue PointsSM.
BlueExtrasSM Discounts “Health care dollars go farther … just by being a BCBSTX member” Look forfurther information about the BlueExtras DiscountProgram at WWW.BCBSTX.com
Treatment Cost Advisor™ • Research the cost of health care expenses. • Provides a summary of estimated costs on a range of procedures, surgeries and tests • Costs are calculated using member’s demographic data, such as ZIP code, city/state, age group or gender • Cost estimates based on Usual and Customary or on CMS data
Hospital Comparison Tool • View hospital profiles and compare hospitals online. • Compare how local hospitals measure up in treating over 150 different diagnoses and procedures • View quality and performance measures • Read detailed hospital profiles with quality indicators Hospital data is self-reported
What if I Have Questions • Personalized Service 8am – 8pm • Our Philosophy – “Take the Member Out of the Middle” • Call your dedicated customer service team for: • Benefit Information • Network provider information • Membership and eligibility • Inquiries (telephone and e-mail) • ID card requests • Claims Inquiries • Help with online tools! Toll-free Customer Service 866-295-1212