MIIA - Blue Cross Blue Shield Proposed Benefits

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MIIA - Blue Cross Blue Shield Proposed Benefits
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Plan Offerings

• HMO Blue New England (HMO)
• Blue Care Elect Preferred (PPO)

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HMO Blue New England HMO Blue

• Use HMO Blue Network Providers
• PCP Required Change Anytime
• Referrals To Network Specialists
• No Referrals For OB/GYN Care, Chiropractic
  Care, Outpatient Behavioral Health Visits,
  Routine Vision Exam, Emergency Or Out-Of-Area
  Urgent Care

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Blue Care Elect Preferred (PPO)

• No Primary Care Physician Needed
• No Referrals Needed For Specialty Care
• National Network Ability to have services
  rendered out of state at the same out of pocket
  cost as HMO members

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Find A Blue Cross Network Provider

• Visit www.bluecrossma.com
• Call Physician Selection Service 1-800-821-1388
• Ask Your Providers If They Are In The HMO Blue
  Network

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Proposed Changes

• Addition of a plan year deductible for some
  services - 250 Per Individual, 750 Per Family
• Primary Care Physician Office Visits
• Specialist Office Visits
• Emergency Room Visits
• MRI, CT and PET Scans
• Prescription Drugs

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Services That Are Not Subject to the Deductible

• SERVICES THAT ARE NOT SUBJECT TO DEDUCTIBLE
• Preventive Visits, Related Tests Immunizations
  You Pay 0 (no change)
• Diagnostic PCP, OB/GYN, Nurse Practitioner
  Visits You Pay 20 (today you pay 10 to 20
  per visit)
• Mental Health Office Visits You Pay 15 (today
  you pay 10)
• Other Professional Providers Specialist Visits
  You Pay 35. (today you pay 25)
• Prescription Drugs You Pay 10/25/50 for a 30
  day supply, 20/50/110 through Mail Service.
  (today you have a 10/20/40 for retail, 20/40/90
  mail.)
• Chiropractic Visits You pay 20 (today you pay
  15)
• Short Term Rehabilitation Therapy You Pay 20
  (today you pay 15)
• Speech, hearing, and language disorder treatment
  You Pay 20 (today you pay 15)

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Services Subject To The Deductible

• After You Pay 250/750. Plan Year Deductible,
  Then
• Diagnostic Labs, X-Rays Other Tests You Pay
  0 (today you have no deductible)
• CT, Pet Scans and MRI - 100 per category of
  tests ( today you pay 0 with no deductible)
• Emergency Room You Pay 100 (today you pay 100
  with no deductible).
• Inpatient Admissions You Pay 300 at a lower
  cost hospital, 700 at a higher cost hospital.
  (today you pay 200 for Lower cost hospitals and
  400 for higher cost hospital with no deductible)
  
• Surgical Day Care You Pay 150 per admission
  after deductible (today you pay 150 and have no
  deductible)
• Hospice and Home Health Care - 0 after
  deductible (today you pay nothing with no
  deductible)
• Durable Medical Equipment You Pay 0 after
  Deductible (today you pay 0 with no deductible)
• Prosthetic Devices You pay Nothing after
  deductible (today you pay 20 co-insurance)

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Why Change?

• Benefits will not change for a period agreed upon
  by management and labor)
• No hidden out of pocket costs
• No off anniversary rates increases
• Deductible is plan year not calendar year

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Out-Of-Pocket Maximum

• Current Plan
• 600 Enhanced Tier admission out of pocket
  maximum
• 1200 out of pocket maximum for Standard or basic
  tier admission
• 300. out of pocket maximum for Surgical Day Care
  Admissions.
• New Plan
• 1200 out of pocket maximum for all inpatient
  admissions
• 600 out of pocket maximum for surgical day care
  admissions

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Healthy Living

• 150 Fitness Benefit
• 150 Weight Loss Benefit
• Childbirth Class Benefit
• Living Healthy Babies
• Blue Care Line 1-888-247-BLUE (2583)
• Living Healthy Vision Discounts
• Living Healthy Naturally Discounts
• Safe Beginnings Discounts

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Member Central Account

• Visit www.bluecrossma.com
  
• Create An Online Account, Then You Can
• Change Your PCP
• Request An ID Card
• Review Your Plan Benefits
• Review Your Claims
• Track Your Deductible Coinsurance
• Enroll In My Blue Health

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Questions?

• For Provider Information Or Questions
• On Your Membership, Benefits, Referrals Or Claims
• Call Member Service Toll-free Number On ID Card
• Monday - Friday, 8 a.m. - 6 p.m.
• Or Visit www.bluecrossma.com