Blue Cross Blue Shield PPO | Human Resources You'll find detailed plan documents under the My Coverage section. State Employee Health Benefits Program 109 SW 9th St #600 Topeka, KS 66612 785-368-6361 Learn more. This summary does not reflect each and every benefit, exclusion and limitation which may apply to the coverage. Medical Benefits - Blue Cross and Blue Shield of Texas SUMMARY OF BENEFITS. Introduction This brochure describes the benefits of the Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Standard and FEP Blue Basic Options under contract (CS 1039) between the Blue Cross and Blue Shield Association and the United States Office of Personnel Management, as authorized by the Federal Employees Health Benefits law. No: Blue Shield of California administers their own prescriptions. Use the Search box below to search for an SBC by Group Number or Plan Number. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Summaries of Benefits and Coverage - Horizon Blue Cross ... The SBC shows you how you and the plan would share the cost for covered health care services. Effective September 23, 2012, all health plans and employers are subject to new Affordable Care Act (ACA) requirements regarding information provided to members through a standardized plan document know n as a Summary of Benefits and Coverage (SBC). Stand-alone plans offer additional prescription drug coverage only and are an option if you are on Original Medicare insurance or you have a Medicare health plan that does not include Part D coverage. The protection of your privacy will be governed by the privacy policy of that site. . For 58 years, we've been the number one health insurance choice for federal employees and their families. Bronze Plans . The Summary of Benefits and Coverage (SBC) rule is a provision of the Affordable Care Act (ACA). Horizon Blue Cross Blue Shield of New Jersey is an independent licensee of the Blue Cross Blue . Blue Cross and Blue Shield of Louisiana and its subsidiaries, HMO Louisiana, Inc. and Southern National Life Insurance Company, Inc., comply with applicable federal civil rights laws and do not exclude people or treat them differently on the basis of race, color, national origin, age, disability or sex. Operating hours are Monday - Friday from 7 a.m. - 5 p.m. CST. Thank you for your interest in Blue Cross and Blue Shield of Illinois. You pay a $250 deductible and 20% of the costs of services. This comprehensive supplement plan offers robust coverage. If you need inpatient care, call the Blue Cross Blue Shield Global Core Service Center at (800) 810-2583 to arrange direct billing. BlueCross Rx Value (PDP) is a Basic Alternative 2021 Medicare (Part-D) Prescription Plan by Blue Cross Blue Shield of South Carolina. An authorized Blue Cross and Blue Shield of Texas agent will contact you. BCBS 28231 ACA BCK Coins 8150 Rev. These SBCs describe key features such as the covered benefits, cost-sharing provisions . NOTE: Information about the cost of this plan . $0. BlueCross Rx Value (PDP) is a Basic Alternative 2021 Medicare (Part-D) Prescription Plan by Blue Cross Blue Shield of South Carolina. Register or download the Sydney Health app to access all our digital tools, including claims, benefits, pharmacy, and ID cards. Anthem Blue Cross and Blue Shield University of Missouri Science and Technology - SHIP: International Students Coverage for: Individual + Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. $30 copay per evaluation; up to 2 per year Rewards Program Earn $50 for completing the Blue. To help you make an informed choice, Blue Shield of California makes available a Summary of Benefits and Coverage (SBC) explaining your coverage. The Blue Advantage Complete (PPO) has a monthly premium of $0 and has an in-network Maximum Out-of-Pocket limit of $5,100 (MOOP). $29. The Summary of Benefits tells you about some of the plan's features. Empire Blue Cross and Blue Shield: City of New York Hospital Only Plan GHI - CBP Hospital Coverage for: Individual + Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Blue Cross Blue Shield of Massachusetts provides a Summary of Benefits and Coverage (SBC) with online access to the corresponding coverage policy to all of our fully insured members and accounts. As of September 23, 2012, Blue Cross Blue Shield of Massachusetts has been creating Summaries of Benefits and Coverage on behalf of fully insured and self-funded accounts upon renewal, application, or request. If you are unable to locate your SBC, or wish to have an SBC sent to you free of charge, call 1-800-352-2583. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association Page 1 of 8 . Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2021 - 12/31/2021 Blue Cross & Blue Shield of Rhode Island: Lifespan Health - UNAP Coverage for: See below Plan Type: PPO Custom_G01002810_MHM02366_20210101_20211231_PHMC2C_C Lifespan Health UNAP w Acu_01_V To view your coverage policy document, select the size of your employer group, then the plan name listed at the top of your SBC. Want to view claims, statements, costs and benefits? A document that lists the plan's benefits. No thanks, I'm still looking. Dental, vision, hearing and OTC. In the event of a discrepancy between the information in this summary and the certificate of coverage, the certificate will prevail. Independent licensee of the Blue Cross and Blue . You can also learn how to get the most of your pharmacy benefits. Thank you for taking time to learn more about the Blue Cross and Blue Shield Service Benefit Plan. For more information, log in to your account at bcbsm.com. Blue Shield of California (HMO) Blue Shield Access+ HMO; Blue Shield Trio HMO; Blue Shield of California (800) 334-5847. Florida Blue and Florida Blue HMO do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of their plans, including enrollment and benefit . Summary of Benefits Anthem Dental Essential Choice . Explanation of benefits: An explanation of benefits is a notification provided to members when BCBSTX processes a health care claim. Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services. For nearly 60 years, we've been committed to offering individuals like you the best healthcare coverage in the U.S. Standard Option Basic Option FEP Blue S B F Focus 11/21 Page 1 of 8 Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: 01/01/2022 - 12/31/2022 Blue Cross & Blue Shield of Mississippi: Coverage for: Individual | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Summaries of Benefits and Coverage Summaries of Benefits and Coverage. The Blue Cross Medicare Advantage Choice (PPO) has a monthly premium of $79.20 and has an in-network Maximum Out-of-Pocket limit of . . In Virginia, CareFirst MedPlus and CareFirst Diversified Benefits are is the business names of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). The SBC shows you how you and the plan would share the cost for covered health care services. All our plans follow the Affordable Care Act guidelines and provide the same set of essential health benefits, quality and amount of care. To view your coverage policy document, select the size of your employer group, then the plan name listed at the top of your SBC. This is one of our more affordable Medicare Advantage PPO plans. Contact us. Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. The New Blue Medicare Sapphire card is an annual $500 debit card to help reduce out-of-pocket dental, vision or hearing expenses. This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. Premera Blue Cross is an independent licensee of the Blue Cross Blue Shield Association serving businesses and residents of Alaska and Washington state . Check if any of these changes may impact you. It pays for most of your out-of-pocket expenses and covers gaps in your Medicare coverage. This plan includes additional Medicare prescription drug (Part-D) coverage. The SBC shows you how you and the plan would share the cost for covered health care services. Blue Shield (EPO) Blue Shield of California (800) 334-5847. Claims: A claim is a request for payment from Blue Cross Blue Shield of Texas for the medical or mental health services you get. Group Benefit Booklets and Summaries of Benefits and Coverage (SBC) . You should refer to the Summary of Benefits for: Submit an online request for a copy to be mailed to your home. Coverage Period: 01/01/2021 - 12/31/2021 . Recent articles. Blue Cross and Blue Shield Service Benefit Plan: Standard Option Coverage for: Self Only, Self Plus One or Self and Family | Plan Type: PPO 1 of 8 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Learn how Anthem is providing help for members impacted by the California wildfires. Compare health insurance plans from Blue Cross and Blue Shield of Alabama to find the coverage that's right for an individual, family or employer. Therapeutic massage. MyBlue® Customer eService is your source to access your claims, view your Explanations of Benefits (EOBs) and review a summary of your healthcare finances in your Financial Dashboard.. You can also quickly find benefits and coverage information for common procedures and services based on your plan in our new . This plan includes additional Medicare prescription drug (Part-D) coverage. Our BlueMedicare PPO Plans. Plan Information. The intent of the rule is to provide consumers and customers with an easy way to understand their coverage. New member? No referrals to see in-network doctors. Call us at 1-877-393-6733 (1-877-219-5457 for the speech- and hearing-impaired), 8 a.m. to 8 p.m., seven days a week. Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: on or after 01/01/2022 HMO Blue Basic $2750 Deductible Coverage for: Individual and Family | Plan Type: HMO Individual Coverage: The Plan begins to pay benefits when the individual deductible is met. The SBC shows you how you and the plan would share the cost for covered health care services. Blue Cross Blue Shield: State of Michigan Actives, Group 007000562 Coverage for: Individual or Family | Plan Type: PPO . The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital . For more detailed information on what plans cover, refer to the Evidence of Coverage. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2022-12/31/2022 Anthem Blue Cross and Blue Shield: Gold HRA Coverage for: You, You+Spouse or Child(ren), You + Family | Plan Type:HRA The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Blue Advantage Complete (PPO) H0104-014 is a 2022 Medicare Advantage Plan or Medicare Part-C plan by Blue Cross and Blue Shield of Alabama available to residents in Alabama. Arkansas dental search. The SBC shows you how you and the plan would share the cost for covered health care services. Mon-Fri, 5:30 a.m. to 7 p.m. PT and Sat, 7 a.m. to 1 p.m. PT. $49. 1 of 10 Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2022 - 12/31/2022 Highmark Blue Cross Blue Shield: my Priority Blue Flex EPO Bronze 3800 Coverage for: Individual/Family Plan Type: EPO Blue Cross and Blue Shield of Louisiana and its subsidiaries, HMO Louisiana, Inc. and Southern National Life Insurance Company, Inc., comply with applicable federal civil rights laws and do not exclude people or treat them differently on the basis of race, color, national origin, age, disability or sex. We hope this booklet shows you why. The SBC shows you how you and the plan would share the cost for covered health care services. 11/21 Page 1 of 8 Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: 01/01/2022 - 12/31/2022 Blue Cross & Blue Shield of Mississippi: Coverage for: Individual | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Account Summary ; Claim Statements ; Reimbursements ; . If you are a Florida Blue member, you can also obtain your current SBC anytime by logging into the Florida Blue Member Portal. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Summary of Benefits and Coverage (SBC) July 12, 2021. We have the tools you need to manage your health care. Learn more. Blue Cross and Blue Shield of Louisiana and its subsidiaries, HMO Louisiana, Inc. and Southern National Life Insurance Company, Inc., comply with applicable federal civil rights laws and do not exclude people or treat them differently on the basis of race, color, national origin, age, disability or sex. Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: 07/01/2021- 06/30/2022 Empire Blue Cross and Blue Shield: City of New York EPO with Rx. 1 of 11 Highmark Blue Cross Blue Shield: Community Blue PPO Coverage Period: 01/01/2016 - 12/31/2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual/Family | Plan Type: PPO Questions: Call 1-866-594-1729 or visit us at www.highmarkbcbs.com. To ensure consistency, SBCs are created using a standard . Coverage for: Individual + Family | Plan Type: EPO . Effective September 23, 2012, all health plans and employers are subject to new Affordable Care Act (ACA) requirements regarding information provided to members through a standardized plan document know n as a Summary of Benefits and Coverage (SBC). Blue Cross Blue Shield FEP Dental complies with all applicable Federal civil rights laws, to include both Title VII and Section 1557 of the ACA. By Blue Cross and Blue Shield of Kansas Posted on May 22, 2019 May 21, 2019 What's on a Summary of Benefits and Coverage (SBC)? View Claims & Statements. The SBC shows you how you and the plan would share the cost for covered health care services. The Blue Cross and Blue Shield Service Benefit Plan is the number one health insurance choice for federal employees, retirees and their families. National dental search. 1 of 7 Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Proposed Coverage Period: 10/01/2020-12/31/2020 Public Education Employees' Health Insurance Plan: Blue Cross Blue Shield of Alabama Coverage for: Individual + Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Search by group ID or plan description for a group's benefit booklet and summary of benefits and coverage (SBC). . BCBS 27780 ACA-BCK 1250 Rev. Blue Cross and Blue Shield Service Benefit Plan: Basic Option Coverage for: Self Only, Self Plus One or Self and Family | Plan Type: PPO 1 of 7 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services. The Summary of Benefits and Coverage includes a description of benefits that we provide for the account. The Federal Employee Program offers you numerous health benefit plans and coverage options. NOTE: Information about the cost of this plan . Dental forms. Some employers offer Blue Cross and Blue Shield Medicare coverage to their eligible retirees. Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Kentucky, Inc. The Summary of Benefits provides a brief summary of what our Medicare Advantage plans cover and what you pay for covered services. If you bought a Blue Cross and Blue Shield of Illinois (BCBSIL) health plan, changes to your 2022 pharmacy benefit program may start on January 1, 2022.1. No Blue Cross and Blue Shield of North Carolina: Blue Value Bronze 7000 HSA Eligible Coverage for: Individual +Family Plan Type: POS B0008202 1of 8 The Summary of Benefits and Coverage (SBC) document will help you choose ahealth plan .The SBC shows you how you and the plan would share the cost for covered health care services. Empire Blue Cross and Blue Shield: City of New York Hospital Only Plan GHI - CBP Hospital Coverage for: Individual + Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. It requires that all carriers, employers and self-insured health plans provide individuals with a uniform summary of their benefits and coverage. . Print. Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: on or after 01/01/2021 HMO Blue Basic Deductible Coverage for: Individual and Family | Plan Type: HMO Arkansas Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association and is licensed to offer health plans in all 75 counties of Arkansas. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association Page 1 of 7 . GET TO KNOW US A LITTLE BETTER coverage just for you coverage for you and one eligible family member, This is only a summary of coverage. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2021-12/31/2021 Anthem Blue Cross and Blue Shield: Gold HRA Coverage for: You, You+Spouse or Child(ren), You + Family | Plan Type:HRA The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. For TTY/TDD call 1-800-955-8771. To ensure consistency, SBCs are created using a standard . Pursuant to Section 1557 Blue Cross Blue Shield FEP Dental does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, age, disability, or sex . Choose your summary of benefits coverage based on whether your income is more or less than 300 percent of the federal poverty level. blue cross blue shield sc plansfemale game show hosts Wednesday, December 29th, 2021 at 12:51 pm In the United States, Puerto Rico and U.S. Virgin Islands. Overview; To help you compare all of the bronze plans, we are providing the Summary of Benefits and Coverage (SBC) documents below. To find out if you are eligible, reach out to your company benefits representative and ask if a company-sponsored Blue Cross and Blue Shield Medicare plan is available when you retire. Summary of Benefits. Stand-alone plans offer additional prescription drug coverage only and are an option if you are on Original Medicare insurance or you have a Medicare health plan that does not include Part D coverage. Empire Blue Cross and Blue Shield: New York State Employees HMO Coverage for: Individual + Family | Plan Type: HMO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. If you would like personal information on your family's eligibility, benefits or claim status, please call Customer Service at 888-223-4999. These companies are Independent Licensees of the Blue Cross and Blue Shield Association. Empire Blue Cross and Blue Shield: New York State Employees HMO Coverage for: Individual + Family | Plan Type: HMO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Highmark Blue Cross Blue Shield: PPO Blue Coverage for: Individual/Family Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Plan requirements, benefits and coverage: Primary care doctor and telehealth visits. Highmark Blue Cross Blue Shield is an independent corporation operating under licenses from the Blue Cross and Blue Shield Association. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association Page 1 of 8 . Talk to a licensed agent: 833-959-1535 | TTY 711. Picking out a health insurance plan that's best for you and your family is a big decision. Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: on or after 01/01/2021 HMO Blue Basic Coverage for: Individual and Family | Plan Type: HMO Summary of benefits and coverage. Summary of benefits and coverage. If you need a letter explaining international benefits to obtain a travel visa, login to the Member Resource Center and click on 'Coverage While Traveling' to obtain proof of insurance. Benefit Summary. Blue Cross Medicare Advantage Choice (PPO) H5959-014 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Blue Cross Blue Shield of Minnesota available to residents in Minnesota. On this page, you will find links to the Summary of Benefits that are effective for the current plan year. . An SBC can help you understand your current plan or compare plans during Open Enrollment or a Special Enrollment Period. The SBC summarizes important information in a standard format to help you compare across plans. NOTE: Information about the cost of this plan (called the premium) will be . If you aren't clear about any of the underlined terms used in this form, see the Glossary. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association Page 1 of 8 . The aforementioned legal entities, CareFirst BlueChoice, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. Spouse and dependent coverage: The plan begins paying benefits for a covered person when he or she meets the individual deductible amount.It then pays benefits for all covered family members when the family deductible amount is met by any combination of the remaining covered family members. OptumRx is the Pharmacy Benefit Manager (PBM) providing prescription benefits for this health plan. Be sure to check this page often for any changes to your drug list. Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: on or after 01/01/2022. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2021 - 12/31/2021 Highmark Blue Cross Blue Shield: my Blue Access PPO Bronze 3800 Coverage for: Individual/Family Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 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