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. 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 … *A benefit period is the 12 months following your coverage effective date. This is a 3.5-star Medicare Advantage plan. * Please Select Your County: Coverage will begin {{theModel.effectiveDate}} * Zip Code. Nurse Advice Line. Learn how to request a coverage decision, which is also sometimes called an organizational determination. 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 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. Please enter a valid Zip Code. Premera Blue Cross complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Blue Cross of Idaho has determined that the prescription drug coverage is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Blue Cross of Idaho administers COBRA coverage for state of Idaho group members. Costs are lowest for first tier (generic) drugs, and costs increase as the tiers increase. Blue Cross of Idaho enhanced prescription drug benefits by offering early refills on maintenance prescriptions, along with a 90-day supply to ensure members had access to needed medications. In addition, some employer groups may choose to purchase enhanced coverage for preventive drugs. The Blue Cross of Idaho formularies list drugs approved for coverage under your policy. Select Check Drug Cost & Coverage from the Plan & Benefits menu. A deductible is the amount of expenses that must be paid out of pocket before the Initial Coverage period begins. If you would like to know more about Specialty medications, please visit the Specialty Drugs page. Start a file for your FY2021 receipts. You must be logged-in to view this page. Enrollment in Blue Cross of Idaho Care Plus, Inc. depends on contract renewal. Blue Cross of Idaho offers coverage for mammogram screenings. Discover the benefits you want with the affordable coverage you … 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. 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 … Members with questions about coverage or telehealth services should visit bcidaho.com or call the customer service number located on the back of their ID card. To continue coverage, the insured person must elect coverage within sixty (60) days after group coverage terminates. (If you don’t have one, creating one is easy. Policy Notice of Medicare Non-coverage (NOMNC) Reporting. 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. Follow the additional prompts to complete a Cost & Coverage check. *Not included with the True Blue Rx Essentials plan. Receipt of benefits is subject to satisfaction of all terms and conditions of the coverage. Box 8406, Boise, ID 83707 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. Yes. Blue Cross of Idaho received notification earlier this year from Centers for Medicare & Medicaid Services (CMS) of our selection for a contract-level Medicare Advantage (MA) RADV audit to validate health status information for our MA members in 2014. Most employer groups use one of three formularies. Your benefits description contains useful information about the services covered by your plan for the current benefit period. Blue Cross of Idaho Rx offers comprehensive pharmacy benefits for many of our members. In excess of the maximum allowance. If you have already registered, you will go directly to your CVS Caremark pharmacy benefits page. Details Drug Coverage for the Blue Cross of Idaho True Blue Rx Option II H1350-016 (HMO) in Idaho. Get more information on Healthy Smiles plans. You can learn more about cost-sharing, coverage limitations, and if you need a referral to see a specialist. 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. Blue Cross of Idaho … Uniform Glossary , which is a list of definitions that explains terms commonly used in health insurance coverage, such as "deductible" and "copayment." Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts. Review the Benefits at a Glance FY2021. 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. Sort by Facility or City. Select Access Your Pharmacy Benefits Now – You will be redirected to the CVS Website. The policies are used for the express purpose of assisting physicians and other healthcare providers in providing evidence based cost effective care. Details Drug Coverage for the Blue Cross of Idaho True Blue Rx Gem H1350-024 (HMO) in Idaho. Any time, day or night, you can speak with a registered nurse at no cost to you. You can search other benefit periods to review previous benefit descriptions. 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. Please click the button below to access your benefits. Exam and Hardware Allowance Benefit Summary (31KB) Exam and Full Hardware – With three different exam and full hardware plans, you can offer your employees the maximum vision benefit. Blue Cross of Idaho partners with IngenioRx to provide pharmacy benefits to most of our membership. You can also contact one of our district offices at 800-345-4550. Generic drugs are equivalent to brand-name drugs in dosage, safety, strength, route of administration, quality, performance characteristics and intended use. You’ll need your Blue Cross of Idaho member ID card to get started.). 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) Members have the option to purchase the three supplemental benefits below for an additional $39.00 per month. Find a provider in your area! POWERED BY BLUE CROSS OF IDAHO CARE PLUS, INC 3 . Active Policy. Please enter a valid Zip Code. 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. In addition to the tiers, certain preventive drugs may be covered at no cost. Sales Guide; Outline of Coverage (includes monthly premium rates) Application; 2021 Monthly Premium Rates For fast (expedited) coverage decisions, call the same number at 1-888-494-2583 (TTY 711). Sort by Facility or City. Protect yourself from the coverage gaps in Original Medicare and live healthier with our Medicare Advantage plans. To obtain a cost estimate for prescribed medications, based on your current benefits and accumulations, complete the following steps: For questions regarding cost estimates obtained through the CVS website, or to obtain a cost estimate for your prescriptions over the phone, please contact CVS Caremark Rx Customer Care. The Preventive Drug List (2020 and 2021) provides a list of medications covered under the preventive drug benefit . To request an informational/enrollment packet, contact Blue Cross directly at 1-800-289-8613 ext. The Healthy Smiles Advantage. Sign on and check your benefits today! You can also contact us to ask for a coverage decision before you receive certain medical services. Preventive medications are generally prescribed for people who may be at risk for certain illness or condition, but are not yet showing symptoms. Blue Cross of Idaho’s Summary of Benefits and Coverage (SBC) provides detailed information about your health coverage options and benefits. You’ll need your Blue Cross of Idaho member ID card to get started.) Medical policies consist of medical guidelines, including diagnostic imaging management policies, payment guidelines and evidence-based guidelines. Plan brochure. MP 3.01.508 - Neuropsychological Testing - Effective 08/25/2020; Pending Policy. payment to your local Blue Cross of Idaho district office (listed on the back of this brochure). 8211. You can learn more about cost-sharing, coverage limitations, and if you need a referral to see a specialist. Qualified Health Plan Formulary - 6 Tier for Metal Level Plans - For individual and small group Affordable Care Act plans that are available through the healthcare exchange at Your Health Idaho or directly through Blue Cross of Idaho. You have the option to choose a brand-name medication when a generic equivalent exists. Follow the additional prompts to complete a Cost & Coverage check. 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. MEDICARE. Blue Cross of Idaho, an independent licensee of the Blue Cross and Blue Shield Association, is the state's largest health insurer, providing coverage for nearly 550,000 members. I understand that by signing this application, I authorize Blue Cross of Idaho to change my coverage, including covered dependents, to the policy I’ve checked above. Quantity Limits for Commercial and Qualified Health Plans are included in the formulary. 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. 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. This is a 3.5-star Medicare Advantage plan. 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. Knowing the details of your health insurance allows you to use all the benefits your plan offers, and be prepared when you need to make a medical decision. 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. Be sure to read the "exclusions and limitations" in the 2020 Short Term PPO Brochure before buying a plan. Secure Blue Plan Premium Table. 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 The formularies also provide information regarding the following: Most employer groups use one of three formularies. Sign on and check your benefits today! 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. FY2021 COBRA Premium Rate (Start July 1) FY2021 COBRA Rates – MEDICAL Contact your insurange agent or Blue Cross of Idaho account representative to find an affordable health coverage option for your business. Details Drug Coverage for the Blue Cross of Idaho True Blue Rx Preferred H1350-021 (HMO) in Idaho. Blue Cross of Idaho provides health insurance, dental insurance, and medicare advantage coverage to the residents of Idaho. For fast (expedited) coverage decisions, call the same number at 1-888-494-2583 (TTY 711). Write Blue Cross of Idaho Care Plus, P.O. 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. 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). But if you want to, you can also use … Plans for Everyone. If this is the first time you are visiting CVS Caremark, you will be asked to register. VIEW YOUR SBC. Call (800) 704-0727to ask questions about your prescriptions, finding a doctor or specialist, or understanding a health condition. Our medical policies are designed for informational purposes only and are not an authorization, explanation of benefits or a contract. Once you have Medicare Part A and Part B, you can enroll in a Idaho MedPlus Medicare Supplement plan. To help fill the gaps in your Medicare coverage, Blue Cross of Idaho Care Plus offers Idaho MedPlus Medicare Supplement plans. Find a provider in your area! 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). We offer affordable choices that: 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. Refer to the Blue Cross of Idaho Care Plus, Inc. Summary of Benefits for more information. The True Blue Rx Gem (HMO) has a monthly premium of $15.00 and has an in-network Maximum Out-of-Pocket limit of $5,400 (MOOP). 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