Get access to your online account. But they also give you the most access to Michigan's largest HMO network. PDF Blue Cross Blue Shield of Michigan: Understanding member ID cards A "PPP" is a Primary Preferred Provider in the Blue Preferred an d PPO Provider networks. Register Now, Not registered? Blue Cross Blue Shield of Michigan and Blue Care Network members. In 2019, you can choose a primary care physician to coordinate your care from any Michigan county. Doctors and hospitals in our Blue Cross Preferred network have to meet strict standards such as: Doctors: Board certification Acceptable malpractice claim history A state license with no disciplinary actions Hospitals: Accreditation by a nationally recognized organization Centers for Medicare & Medicaid Services certification Insurance Plans | Michigan Medicine 1996-2023 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. Register Now, Not registered? Authorizations are often required for procedures such as surgery or MRI. If you don't have access to the provider portal, learn how to get an account. You'll need to submit a prior authorization request and follow our medical policies to avoid a rejected claim. Blue Cross commercial only. We recommend that you check with your insurance company to confirm benefit coverage prior to scheduling an appointment. Prior Authorization and Step Therapy Guidelines for Preferred Drug List (PDF) Download. We recommend that you check with your insurance company to confirm benefit coverage prior to scheduling an appointment. Individual and Family Plans . A Blue Cross . Individuals attempting unauthorized access will be prosecuted. Our Preferred plans have higher monthly payments than our other HMO plans. For Providers: Submit Medicare drug prior authorizations | BCBSM Blue Care NetworkAdvantage (BCN) Medicare, Blue Cross Blue Shield Federal Employee Program, Blue Cross Blue Shield of Michigan(BCBSM), Blue Cross Blue Shield of Michigan(BCBSM) Medicare, Health Alliance Plan (HAP) Medicare Plans, PHP of Northern Indiana HMO/PPO (specialty services only), Private Health Care Systems (PHCS)/Multiplan, UnitedHealthcare Community Plan(Michigan Only), Report Sexual Misconduct, Discrimination and Harassment, Copyright 1995-2022 Regents of the University of Michigan. 24-Hour Nurse Line Talk to a registered nurse at no additional cost anytime when you have questions about an illness or injury. Not Registered? Register Now, Not registered? You can learn more by clicking the relevant link in the Blue Cross or BCN section on ourereferrals.bcbsm.com website. Find a Doctor Blue Cross Preferred HMO plans View Map Our Preferred plans have higher monthly payments than our other HMO plans. January 1, 2022 - December 31, 2022 www.bcbsm.com/mpsers Turnip Rock Port Austin, Michigan About the medical plan When you retire, you and your eligible dependents can enroll in health care coverage through the Michigan Public School Employees' Retirement System. Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader, You can find which drugs need prior authorization by viewing our, If you don't have access to the provider portal, learn how to, Medicare Advantage Medical Drug Prior Authorization and Step Therapy List (PDF), Aduhelm (aducanumab-avwa) medical policy (PDF), Alpha-1 proteinase inhibitors medical policy (PDF), Botulinum toxin type A medical policy (PDF), Botulinum toxin type B medical policy (PDF), Calcitonin Gene Related Peptide Antagonists medical policy (PDF), Carvykti (ciltacabtagene autoleucel) medical policy (PDF), Colony stimulating factors medical policy (PDF), Duchenne Muscular Dystrophy medical policy (PDF), Enjaymo (sutimlimab) intravenous injection medical policy (PDF), Enzyme Replacement Therapy for Fabry Disease medical policy (PDF), Enzyme replacement therapy for Gaucher's Disease medical policy (PDF), Enzyme replacement therapy for Mucopolysaccharidosis medical policy (PDF), Enzyme Replacement Therapy for Pompe Disease medical policy (PDF), Hyaluronic acid intra-articular injections medical policy (PDF), Immune globulin replacement therapy medical policy (PDF), Intravenous Iron Replacement medical policy (PDF), (voretigene neparvovec-rzyl) medical policy (PDF), Pulmonary arterial hypertension medical policy (PDF), Vyjuvek (beremagene geperpavec) medical policy (PDF), Xenpozyme (olipudase alfa-rpcp) medical policy (PDF), Important Information About MedicarePlans. If an authorization is required, University of Michigan Health System clinic staff will obtain the authorization from your health plan prior to the service. 1996-2023 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. Your physician can refer you to over 16,500 specialists and 141 hospitals. Just ask your local pharmacy. You can find VSP eye care professionals who accept our plans by searching vsp.com. Some unique selffunded products have their own names, such as Blue Preferred Plus, a PPO product for auto groups in a 21county network, GeoBlue . Date posted: May 9, 2023 Additional fee change schedules added to our provider portal Blue Cross Blue Shield of Michigan recently added these additional fee change schedules to our provider portal, as of 05-12-2023: Professional Traditional, TRUST and Blue Preferred PlusSM (BPP) Injections Facility Hospital Outpatient View our medical policies to learn about our drug guidelines. State and Federal Privacy laws prohibit unauthorized access to Member's private information. Individuals attempting unauthorized access will be prosecuted. All Blue Cross Blue Shield of Michigan member ID cards have the same basic layout, but the information on each card may vary slightly, depending on the member's benefits. You can submit your request by logging in to the provider portal or using Novologix. Important Legal and Privacy Information|Important Information About Medicare Plans|Privacy Practices 1996-2023 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross . Prior-Authorization And Pre-Authorization | Anthem.com You'll need to submit a prior authorization request and follow our medical policies to avoid a rejected claim. Medicare Plus Blue PPO Vitality (PPO) H9572-002 Blue Cross Blue Shield of Michigan | Local PPO Other Plan Options Other Plan Options Ready to Buy a Medicare Plan? State and Federal Privacy laws prohibit unauthorized access to Member's private information. This page provides Blue Cross Blue Shield of Michigan's prior authorization requirements, including information that applies to: Blue Cross commercial and Medicare Plus Blue. Urgent care centers Get access to your employer portal.Register Now, Learn more about registering for our web tools.Register Now, Not registered? We provide health insurance in Michigan. PDF 2022 Non-Medicare Blue Preferred PPO - Blue Cross Blue Shield of Michigan Important Legal and Privacy Information|Important Information About Medicare Plans|Privacy Practices Many insurance plans require referrals and/or authorizations in order for services to be covered. We provide health insurance in Michigan. Register Now, Not registered? bcbsm.com Customer Service: 800-662-6667 TTY/TDD: Tolocate participating800-257-9980 providers outside of Michigan: 800-810-2583Misuse may result in prosecution.If you suspect fraud: 800-482-3787Mental health/substance abuse treatment: 800-482-5982 888-826-8152Dental Servicing: For Behavioral Health benefits, participation status may vary here at Michigan Medicine. Click Coronavirus on the Member Care tab. For Behavioral Health benefits, please contact your plan directly, as they may have chosen to use a different company to administer these benefits which we may not accept. Doctors and hospitals in our Blue Cross Preferred network have to meet strict standards such as: 1996-document.write(new Date().getFullYear()); Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. Click Secure Provider Resources (Blue Cross and BCN) on the Resources tab. For Providers: Medicare prior authorization | BCBSM Blue Cross Authorization Requirements & Criteria Non-Michigan providers who treatMedicare Advantage members who travel or live outside of Michigan should review the following documents: 1996-2023 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. If you arrive for services without a referral in place, you may be asked to sign a waiver that holds you financially responsible for the services you receive. A referral is permission from your primary care physician and your health plan to see a particular provider or to have specific procedures done. PDF Blue Care Network: Understanding member ID cards - Blue Cross Blue Not registered? You can submit your request by logging in to the provider portal or using Novologix. Get access to your agent portal.Register Now. In 2019, you can choose a primary care physician to coordinate your care from any Michigan county. See the links within the accordions for information on prior authorization requirements for specific services. Need to treat a Blue Cross Medicare Plus BlueSM PPO and BCN AdvantageSM HMO-POS or BCN Advantage patient with medical drugs at a provider office, an outpatient facility location or the patients home? Patient & Visitor Guide For Patients Insurance Plans Insurance Plans Michigan Medicine participates with most health insurance plans. Get access to your online account. State and Federal Privacy laws prohibit unauthorized access to Member's private information. In the meantime, you can submit your prior authorization request by locating the appropriate form on this page and faxing it. Get access to your agent portal. In the meantime, you can submit your prior authorization request by . Register Now, Learn more about registering for our web tools. Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). Get access to your employer portal. See the links within the accordions for information on prior authorization requirements for specific services. Blue Preferred PlusSM 0020 $2,500 Deductible Plan Highlights copayments, deductible, out-of-pocket limits, member coinsurance percentage amounts, and provides a brief description of Blue Preferred Plus Health Care Plan benefits. PDF Blue Preferred Plus SM 0020 - BCBSNM Register Now, Not registered? PDF Additional fee change schedules added to our provider portal These plans cover vision care for members who are age 18 and younger. Some services for Medicare Plus Blue SM PPO and BCN Advantage SM members require practitioners and facilities work with us or with one of our contracted vendors to request prior authorization before beginning treatment.. Register Now, Learn more about registering for our web tools. Not registered? PDF Blue Cross Complete Transportation Services Individuals attempting unauthorized access will be prosecuted. Blue Prefe rred Plus_0000_10 00_2021_2022 Customer Service: (800) 432-0750 1/2 Footnotes: The deductible must be met before benefit payments are made for services with coinsurance. Site Map|Feedback|Download Adobe Acrobat Reader, Learn more about a Healthier Michigan.org, Important Information About Medicare Plans. Get access to your member portal. ACA Marketplace plans for individuals, families and small businesses. Login | My online account | bcbsm.com We recommend that you always check with your insurance plan before scheduling these type of services. With 98 percent of Michigan pharmacies in our network, it's easy to find one that accepts these plans. Register Now. Call 1-800-775-BLUE (2583). But they also give you the most access to Michigan's largest HMO network. PDF Blue Preferred Plus SM 0000 - BCBSNM Michigan Health Insurance. Shop Plan Now 2023 Overall. Not Registered? We provide health insurance in Michigan. For billing and insurance questions, please contact Patient Customer Services at: Below is a list of insurances that Michigan Medicine participates with based on Medical benefits. Get access to your online account.Register Now, Not registered? Register Now. Get access to your agent portal. Register Now, Not registered? For Providers: Authorization and step therapy | BCBSM