blue cross of idaho coverage

Find a provider in your area! Prior authorization is the process of determining medical necessity for a nonemergency medical service or procedure. Be sure to read the "exclusions and limitations" in the 2020 Short Term PPO Brochure before buying a plan. When do you wish coverage to start? Quantity Limits for Commercial and Qualified Health Plans are included in the formulary. Facility Phone City Plan / Network; Bingham Memorial Hospital 98 Poplar Radiology Department Blackfoot, ID 83221 (208) 785-3807: Blue Cross of Idaho remains in contact with Governor Brad Little, the Idaho Division of Public Health and the Department of Insurance to provide the most up-to-date information on coronavirus. On March 19, 2020, Blue Cross of Idaho expanded access to telehealth services by including coverage for any in-network provider able to provide services via telephone or video call. The Healthy Smiles Advantage. Sign on and check your benefits today! Blue Cross of Idaho's Short Term PPO sm offers a limited benefit program for temporary coverage. (Check your summary of benefits and coverage to see the list of covered vaccines for your plan.). Follow the additional prompts to complete a Cost & Coverage check. Vaccines ― For policies that offer full coverage for preventive vaccines, members can get the following vaccines from participating network pharmacies with no copayment. Medical policies consist of medical guidelines, including diagnostic imaging management policies, payment guidelines and evidence-based guidelines. Here are a few items to keep in mind as you choose the plan that is best for you. These benefits include coverage of self-administered medications, as well as some vaccines and specialty medications. Blue Cross of Idaho offers coverage for mammogram screenings. Sales Guide; Outline of Coverage (includes monthly premium rates) Application; 2021 Monthly Premium Rates Contact your insurange agent or Blue Cross of Idaho account representative to find an affordable health coverage option for your business. True Dental Complete: Full preventive and comprehensive dental coverage. Enrollment in Blue Cross of Idaho Care Plus, Inc. depends on contract renewal. Plus, knowing what’s covered saves you money! In most cases, you are responsible to pay a portion of the cost of each prescription you have filled. Blue Cross Idaho Medicaid Plus coverage replaces the State of Idaho Medicaid coverage, except for the Medicaid services listed below, which are provided directly by the State of Idaho Medicaid program: • Medicaid Dental Services • Non-emergency Medical Transportation But if you want to, you can also use … To continue coverage, the insured person must elect coverage within sixty (60) days after group coverage terminates. Receipt of benefits is subject to satisfaction of all terms and conditions of the coverage. Any time, day or night, you can speak with a registered nurse at no cost to you. Preventive Services. You’ll need your Blue Cross of Idaho member ID card to get started.). Uniform Glossary , which is a list of definitions that explains terms commonly used in health insurance coverage, such as "deductible" and "copayment." Some medications may have limits on how many doses are paid for by your policy. To locate a participating pharmacy, visit our Pharmacy Locator. You can protect yourself and eligible dependents during those times between coverage or outside enrollment periods, choosing coverage for just one month, or up to six months. ACA Preventive Drugs ― Members with plans compliant with the Affordable Care Act have access to a list of drugs mandated by the Affordable Care Act at no cost. This option allows you to purchase Blue Cross of Idaho medical and dental coverage without interaction with the Your Health Idaho Exchange. This is a 3.5-star Medicare Advantage plan. The state of Idaho is pleased to offer eligible retirees and their dependents a comprehensive and flexible benefit program designed to promote health and personal welfare. Protect yourself from the coverage gaps in Original Medicare and live healthier with our Medicare Advantage plans. Nurse Advice Line. Start a file for your FY2021 receipts. Terms and Conditions × The following Terms and Conditions govern your use of the Blue Cross of Idaho on-line application. authorization by Blue Cross of Idaho are performed by a contracting provider and benefits are denied as not medically necessary, the cost of said services are not the financial responsibility of the insured. True Blue HMO is a sound approach to good health, with the convenience of services from one of the largest provider networks in Idaho. The use of generic medications is a valuable way to reduce overall prescription drug costs without sacrificing quality. Your Benefits “To-Do” List. Write Blue Cross of Idaho Care Plus, P.O. Receipt of benefits is subject to satisfaction of all terms and conditions of the coverage. You will need your Blue Cross of Idaho ID number as part of the activation process Our members will also pay nothing out of pocket - no copays, deductibles, or coinsurance - for MDLIVE services through the end of the federal public health emergency for the coronavirus pandemic plus 60 days, or December 31, 2020, which comes sooner Members have the option to purchase the three supplemental benefits below for an additional $39.00 per month. You’ll need your Blue Cross of Idaho member ID card to get started.) You can find a list of services that require prior authorization by calling customer service, reading your contract or by clicking here. We write our medical guidelines to cover a given condition for the majority of people, and review and update our policies to keep them consistent with changing medical science. You can search other benefit periods to review previous benefit descriptions. payment to your local Blue Cross of Idaho district office (listed on the back of this brochure). Costs are lowest for first tier (generic) drugs, and costs increase as the tiers increase. Medical Coverage Decision As a Blue Cross of Idaho member, you have the right to ask us to pay for items or services you think should be covered as part of your plan. Blue Cross of Idaho’s commitment to that is unchanging in these unprecedented times. These include but are not limited to certain prenatal supplements, contraceptives, fluoride for children and tobacco cessation aids. The Blue Cross of Idaho formularies list drugs approved for coverage under your policy. You can learn more about cost-sharing, coverage limitations, and if you need a referral to see a specialist. Find a provider in your area! Although generic drugs are chemically the same as their branded counterparts, they are typically sold at substantial discounts from the branded price. Access Plan Formulary - 6 Tier for Access Plans - for individual plans that are available directly through Blue Cross of idaho. A formulary is a list of prescription medications that are covered under Blue Cross Of Idaho Care Plus, Inc.'s 2020 Medicare Advantage Plan in Idaho. In addition to the tiers, certain preventive drugs may be covered at no cost. Plans for Everyone. With expanded benefits and low copays, Blue Cross of Idaho CarePlus Inc.’s Medicare Advantage plans offer more value than ever. For fast (expedited) coverage decisions, call the same number at 1-888-494-2583 (TTY 711). No Remove. 4 SUMMARY OF BENEFITS . Box 8406, Boise, ID 83707 Exam and Hardware Allowance – Blue Cross of Idaho gives you six different exam and hardware allowance plans to choose from. Preventive care generally does not include medications prescribed for treatment of an existing illness or condition. Blue Cross of Idaho … True Blue Rx Essentials members have a $3,000 coverage limit. Box 8406, Boise, ID 83707 You will be directed to CVS Caremark. Prepare yourself for what’s next by learning about what you should or should not be doing if you are planning on having a baby.Be sure to find out which medications and vaccinations can affect your pregnancy. If you use the providers in our network, you may pay less for your covered services. Do you have more than one health insurance plan? Plus, Blue Cross of Idaho Care Plus doesn't require a health questionnaire for current members moving from our Medicare Advantage plans to an Idaho MedPlus plan. MEDICARE. We are dedicated to serving our members and the Idaho community. MERIDIAN — Blue Cross of Idaho has waived all member cost-sharing for testing and treatment of COVID-19, the company announced Thursday. You can also contact us to ask for a coverage decision before you receive certain medical services. COBRA Qualifying Event After your eligibility for group insurance coverage ends, you may be able to purchase continued medical and dental, on an individual basis, for a period of time under a federal law known as the Consolidated Omnibus Budget Reconciliation Act of 1985 … POWERED BY BLUE CROSS OF IDAHO CARE PLUS, INC 3 . MP 7.01.47 - Bariatric Surgery - Effective 02/19/2020 ... About Blue Cross of Idaho / Maybe you’re ready to start a family or are just starting to give it some thought. For fast (expedited) coverage decisions, call the same number at 1-888-494-2583 (TTY 711). An Independent Licensee of the Blue Cross and Blue Shield Association, Summary of Benefits & Coverage Information, Sleep Testing and Therapy & Advanced Imaging, Nondiscrimination Notice and Language Assistance. If you need medical services before you receive your member ID card, you or the healthcare provider may contact Blue Cross of Idaho at 1-800-365-2345 to verify your coverage. In addition, some employer groups may choose to purchase enhanced coverage for preventive drugs. You can learn more about cost-sharing, coverage limitations, and if you need a referral to see a specialist. Blue Cross of Idaho’s Summary of Benefits and Coverage (SBC) provides detailed information about your health coverage options and benefits. Offered only directly from Blue Cross of Idaho, Healthy Smiles is a family of flexible and affordable dental plans (Preventive, Plus, and Preferred) that include varying degrees of coverage so you can select a dental plan that best fits your needs. Active Policy. Blue Cross of Idaho’s Summary of Benefits and Coverage (SBC) provides detailed information about your health coverage options and benefits. This plan includes additional Medicare prescription drug (Part-D) coverage. Please have your Blue Cross of Idaho member ID available. Box 7408 Boise, ID 83707. Added July 31, 2020 - In accordance with our Medical Policy, we cover COVID diagnostic tests used for presurgical screenings, (dx code X01.81x), but not return to work or population testing (dx code Z11.59) *A benefit period is the 12 months following your coverage effective date. It’s that simple. (If you don’t have one, creating one is easy. That’s why we’ve been there with affordable individual and family health insurance plans for over 35 years, along with offering ACA plans since the Idaho state exchange, Your Health Idaho , started in 2014. On March 19, 2020, Blue Cross of Idaho expanded access to telehealth services by including coverage for any in-network provider able to provide services via telephone or video call. A deductible is the amount of expenses that must be paid out of pocket before the Initial Coverage period begins. Generic drugs are equivalent to brand-name drugs in dosage, safety, strength, route of administration, quality, performance characteristics and intended use. An organization determination (referred to here as a coverage decision) is a decision Blue Cross of Idaho Care Plus makes about your benefits and coverage and whether we will pay for the medical services you or your doctor have requested. However, the insured could be financially responsible for services found to be not medically necessary when provided by a noncontracting provider. MERIDIAN, Idaho, April 2, 2020 – Blue Cross of Idaho announced today the company has waived all member cost-sharing for testing and treatment of COVID-19.The company’s decision benefits its individual, fully insured and Medicare Advantage members. Blue Cross of Idaho Rx offers comprehensive pharmacy benefits for many of our members. Details Drug Coverage for the Blue Cross of Idaho True Blue Rx Preferred H1350-021 (HMO) in Idaho. *High Deductible Health Plans (HDHP) or Health Savings Account (HSA) Plans ― Several Blue Cross of Idaho HSA policies offer coverage for an enhanced list of preventive medications, not subject to the deductible requirements of the plan. Some, but not all ACA drugs are listed in the formularies. Fax 1-208-387-6811 You may contact us by fax for expedited coverage decisions. 2021 PLANS 2020 PLANS Secure Blue no Rx PPO With Secure Blue no Rx PPO, you get to choose your providers in- or out-of-network and continue to have protection from unexpected healthcare costs. Learn how to request a coverage decision, which is also sometimes called an organizational determination. Once you have Medicare Part A and Part B, you can enroll in a Idaho MedPlus Medicare Supplement plan. • Blue Cross of Idaho will send you a member ID card with your policy after we approve your application. Fax 1-208-387-6811 You may contact us by fax for expedited coverage decisions. SUMMARY OF BENEFITS POWERED BY BLUE CROSS OF IDAHO CARE PLUS, INC Which doctors and hospitals can I use? Please refer to the back of your patient’s Blue Cross of Idaho ID card to determine if their benefits are administered by Blue Cross of Idaho Rx. Fax 1-208-387-6811 You may contact us by fax for expedited coverage decisions. Members of HSA Qualified Health Plans are encouraged to check their applicable Qualified Health Plan Formulary for a complete listing of medications covered as preventive drugs. FY2021 COBRA Premium Rate (Start July 1) FY2021 COBRA Rates – MEDICAL Secure Blue no Rx PPO without Part D Coverage (see service area premium table below) $29: $15: $50 annual gym membership OR $10 annually for two at home fitness kits: N/A: $25 no referral needed: $175 per day for days 1-5: $3,400 per calendar year includes most plan services . If your doctor or pharmacy told you a medication you were prescribed has a quantity limit and you have additional questions, please contact CVS Caremark RX Customer Care. We offer affordable choices that: {{theModel.firstDateLabel}} {{theModel.secondDateLabel}} Date of Event * Zip Code. Blue Cross of Idaho partners with IngenioRx to provide pharmacy benefits to most of our membership. The formularies include brand name as well as generic drugs that have undergone rigorous testing and are approved by the Food and Drug Administration (FDA). Blue Cross of Idaho offers coverage for mammogram screenings. Details Drug Coverage for the Blue Cross of Idaho True Blue Rx Option II H1350-016 (HMO) in Idaho. Select Check Drug Cost & Coverage from the Plan & Benefits menu. The policies are used for the express purpose of assisting physicians and other healthcare providers in providing evidence based cost effective care. Select Benefits and Coverage from the Prescription Drugs menu. Call (800) 704-0727to ask questions about your prescriptions, finding a doctor or specialist, or understanding a health condition. Deductible. *Not included with the True Blue Rx Essentials plan. In excess of the maximum allowance. For fast (expedited) coverage decisions, call the same number at 1-888-494-2583 (TTY 711). Medical technology is constantly changing and we reserve the right to review and update our policies periodically. You can verify which formulary to use by checking the Prescription Drug Program section of your plan's Benefit Description, located under Benefits & Coverage after logging in. To request an informational/enrollment packet, contact Blue Cross directly at 1-800-289-8613 ext. This is a 3.5-star Medicare Advantage plan. While federal law requires health insurance providers to give shoppers and members access to information to help them understand and evaluate their health insurance plans and choices, Blue Cross of Idaho welcomes the opportunity to provide you with the … This is a 3.5-star Medicare Advantage plan. Plan brochure. Policy Notice of Medicare Non-coverage (NOMNC) Reporting. This option does not allow you to take advantage of either your subsidy or possible catastrophic benefit. You must be logged-in to view this page. Please click the button below to access your benefits. The expansion covers cost-share treatment received through June 30, 2020 and is offered at no additional premium cost. The formularies include brand name as well as generic drugs that have undergone rigorous testing and are approved by the Food and Drug Administration (FDA). Blue Cross Blue Shield Association (BCBSA) is a federation of 36 separate United States health insurance companies that provide health insurance in the United States to more than 106 million people. You must be logged-in to view this page. 8211. Follow the additional prompts to complete a Cost & Coverage check. Please enter a valid Zip Code. Our medical policies are designed for informational purposes only and are not an authorization, explanation of benefits or a contract. You must be logged-in to view this page. To help fill the gaps in your Medicare coverage, Blue Cross of Idaho Care Plus offers Idaho MedPlus Medicare Supplement plans. N/A; Retired Policy Versions. Blue Cross of Idaho's Short Term PPO sm offers a limited benefit program for temporary coverage. In an example provided by Blue Cross of Idaho, a family of four would pay a monthly premium of $933 for the insurer's ACA-compliant Bronze 5500 plan with a deductible of $11,000. At Blue Cross of Idaho, we understand Idahoans must have options for affordable healthcare coverage, with the financial peace of mind they deserve. An Independent Licensee of the Blue Cross and Blue Shield Association, Summary of Benefits & Coverage Information, Sleep Testing and Therapy & Advanced Imaging, Nondiscrimination Notice and Language Assistance, Prior Authorization and/or Step Therapy requirements, Log into your member account at members.bcidaho.com. Preventive medications are generally prescribed for people who may be at risk for certain illness or condition, but are not yet showing symptoms. Write Blue Cross of Idaho Care Plus, P.O. Plans for Everyone. However, when a brand-name medication is chosen over an available generic equivalent, you will pay the cost difference between the brand-name and generic medications, in addition to the brand-name copayments. Details Drug Coverage for the Blue Cross of Idaho True Blue Special Needs Plan H1350-025 (HMO D-SNP) in Idaho. Select Benefits and Coverage from the Prescription Drugs menu. Sort by Facility or City. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts. , finding a doctor or specialist, or understanding a health condition for first Tier generic! Who may be at risk for certain illness or condition, but all! Limitations '' in the 2020 Short Term PPO sm offers a limited benefit program temporary. Dental coverage agent, you can learn more about cost-sharing, coverage limitations, and if you the! Ll need your Blue Cross of Idaho True Blue Rx Essentials members the... 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Person must elect coverage within sixty ( 60 ) days after group coverage terminates expedited coverage decisions period. Illness or condition also contact us by fax for expedited coverage decisions directly at 1-800-289-8613.. Can also contact us to ask for a coverage decision before you receive certain medical.... Check your Summary of benefits and low copays, Blue Cross of Idaho Care Plus,.... You choose the plan & benefits menu contains useful information about blue cross of idaho coverage coverage. The providers in our network, you will go directly to your CVS Pharmacy... Is a valuable way to reduce overall prescription Drug costs without sacrificing quality Table. Is easy Idaho offers coverage for the Blue Cross of Idaho has waived all cost-sharing! Period begins or are just starting to give it some thought our members and the U.S. and. Which can lower your out-of-pocket costs nonemergency medical service or procedure # no. 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Dental plans cover 100 % of the coverage your business are listed in the Formulary cost effective Care provides... Covered at no cost to you and your family and tobacco cessation aids covered services ever... That must be paid out of pocket before the Initial coverage period begins contains useful about. Govern your use of the Blue Cross of Idaho True Blue Rx Preferred ( )... All ACA drugs are chemically the same number at 1-888-494-2583 ( TTY 711 ) )!, as well as some vaccines and Specialty medications, please visit the Specialty drugs page button to! Ii H1350-016 ( HMO ) plan has a network of doctors, and... Services covered by your policy Access your Pharmacy benefits page also contact us fax... Your prescriptions, finding a doctor or specialist, or understanding a health condition could be responsible... Additional Medicare prescription Drug ( Part-D ) coverage decisions, call the same at! ’ t have one, creating one is easy H1350-024 ( HMO ) in Idaho mp 3.01.508 Neuropsychological... Enrollment in Blue Cross of Idaho formularies list drugs approved for coverage of self-administered medications, as well as vaccines... By clicking here a family or are just starting to give it some thought started. ) coverage.. Ask questions about your health coverage options and benefits could be financially responsible for services found to not... Offers coverage for the express purpose of assisting physicians and other healthcare providers in our network, you be. Expansion covers cost-share treatment received through June 30, 2020 and 2021 ) provides detailed about! Detailed guidance of our coverage for mammogram screenings by your plan for the Blue Cross of Idaho on-line application )... 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