You must be logged-in to view this page. Details Drug Coverage for the Blue Cross of Idaho True Blue Rx Preferred H1350-021 (HMO) in Idaho. Box 8406, Boise, ID 83707 In addition to the tiers, certain preventive drugs may be covered at no cost. If you use the providers in our network, you may pay less for your covered services. Your plan includes pharmacy benefits. INDIVIDUAL & FAMILY. For fast (expedited) coverage decisions, call the same number at 1-888-494-2583 (TTY 711). You can learn more about cost-sharing, coverage limitations, and if you need a referral to see a specialist. Blue Cross of Idaho offers coverage for mammogram screenings. Plus, knowing what’s covered saves you money! However, the insured could be financially responsible for services found to be not medically necessary when provided by a noncontracting provider. 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). MP 7.01.47 - Bariatric Surgery - Effective 02/19/2020 ... About Blue Cross of Idaho / Our medical policies are designed for informational purposes only and are not an authorization, explanation of benefits or a contract. Vaccines ― For policies that offer full coverage for preventive vaccines, members can get the following vaccines from participating network pharmacies with no copayment. 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. The use of generic medications is a valuable way to reduce overall prescription drug costs without sacrificing quality. To request an informational/enrollment packet, contact Blue Cross directly at 1-800-289-8613 ext. It’s that simple. Secure Blue no Rx has a network of doctors, hospitals and other providers. For fast (expedited) coverage decisions, call the same number at 1-888-494-2583 (TTY 711). 8211. 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 When do you wish coverage to start? Blue Cross of Idaho offers coverage for mammogram screenings. Preventive medications are generally prescribed for people who may be at risk for certain illness or condition, but are not yet showing symptoms. Please enter a valid Zip Code. The Preventive Drug List (2020 and 2021) provides a list of medications covered under the preventive drug benefit . To help fill the gaps in your Medicare coverage, Blue Cross of Idaho Care Plus offers Idaho MedPlus Medicare Supplement plans. Plan brochure. Nurse Advice Line. 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. Plans for Everyone. In excess of the maximum allowance. FY2021 COBRA Premium Rate (Start July 1) FY2021 COBRA Rates – MEDICAL Costs are lowest for first tier (generic) drugs, and costs increase as the tiers increase. 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 . This option does not allow you to take advantage of either your subsidy or possible catastrophic benefit. Access Plan Formulary - 6 Tier for Access Plans - for individual plans that are available directly through Blue Cross of idaho. You can find a list of services that require prior authorization by calling customer service, reading your contract or by clicking here. In most cases, you are responsible to pay a portion of the cost of each prescription you have filled. If you have already registered, you will go directly to your CVS Caremark pharmacy benefits page. This is a 3.5-star Medicare Advantage plan. 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. Find a provider in your area! True Blue Rx Gem (HMO) H1350-022 is a 2020 Medicare Advantage Plan or Medicare Part-C plan by Blue Cross of Idaho available to residents in Idaho. Policy Notice of Medicare Non-coverage (NOMNC) Reporting. 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. 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. Blue Cross of Idaho partners with IngenioRx to provide pharmacy benefits to most of our membership. The formularies also provide information regarding the following: Benefit Levels, also known as Tiers Once you have Medicare Part A and Part B, you can enroll in a Idaho MedPlus Medicare Supplement plan. If you would like to know more about Specialty medications, please visit the Specialty Drugs page. Exam and Hardware Allowance – Blue Cross of Idaho gives you six different exam and hardware allowance plans to choose from. Blue Cross of Idaho provides health insurance, dental insurance, and medicare advantage coverage to the residents of Idaho. • Blue Cross of Idaho will send you a member ID card with your policy after we approve your application. 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. To locate a participating pharmacy, visit our Pharmacy Locator. We offer affordable choices that: 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. 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. Select Access Your Pharmacy Benefits Now – You will be redirected to the CVS Website. Drugs are categorized into benefit levels, also known as tiers, which determine the amount you pay. Blue Cross of Idaho's Short Term PPO sm offers a limited benefit program for temporary coverage. Box 8406, Boise, ID 83707 Blue Cross of Idaho P.O. 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. Receipt of benefits is subject to satisfaction of all terms and conditions of the coverage. 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. Terms and Conditions × The following Terms and Conditions govern your use of the Blue Cross of Idaho on-line application. Call (800) 704-0727to ask questions about your prescriptions, finding a doctor or specialist, or understanding a health condition. Any time, day or night, you can speak with a registered nurse at no cost to you. These include but are not limited to certain prenatal supplements, contraceptives, fluoride for children and tobacco cessation aids. Get more information on Healthy Smiles plans. Box 8406, Boise, ID 83707 *A benefit period is the 12 months following your coverage effective date. If this coverage expires or you lose eligibility for this coverage, you might have to wait until an open enrollment period to get other health insurance coverage. You’ll need your Blue Cross of Idaho member ID card to get started.). 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. 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. The Blue Cross of Idaho formularies list drugs approved for coverage under your policy. 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. Active Policy. Contact your insurange agent or Blue Cross of Idaho account representative to find an affordable health coverage option for your business. Facility Phone City Plan / Network; Bingham Memorial Hospital 98 Poplar Radiology Department Blackfoot, ID 83221 (208) 785-3807: 4 SUMMARY OF BENEFITS . 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. Active Policy. Sign on and check your benefits today! Since the coverage under Blue Cross of Idaho, is not creditable, depending on how long you go without creditable prescription drug coverage you may pay a penalty to join a Medicare drug plan. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts. To continue coverage, the insured person must elect coverage within sixty (60) days after group coverage terminates. N/A; Retired Policy Versions. Medical technology is constantly changing and we reserve the right to review and update our policies periodically. You must be logged-in to view this page. Generic drugs are equivalent to brand-name drugs in dosage, safety, strength, route of administration, quality, performance characteristics and intended use. Select Benefits and Coverage from the Prescription Drugs menu. Select Check Drug Cost & Coverage from the Plan & Benefits menu. We are dedicated to serving our members and the Idaho community. 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. 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. 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. Secure Blue Plan Premium Table. 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. 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) Preventive Services. With expanded benefits and low copays, Blue Cross of Idaho CarePlus Inc.’s Medicare Advantage plans offer more value than ever. 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. Pre-pregnancy. MP 3.01.501 - Guidelines for Coverage of Mental and Behavioral Health Services. If you don't have an insurance agent, you can search using our Find a Broker tool. Sort by Facility or City. payment to your local Blue Cross of Idaho district office (listed on the back of this brochure). Uniform Glossary , which is a list of definitions that explains terms commonly used in health insurance coverage, such as "deductible" and "copayment." A deductible is the amount of expenses that must be paid out of pocket before the Initial Coverage period begins. 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. At Blue Cross of Idaho, we understand Idahoans must have options for affordable healthcare coverage, with the financial peace of mind they deserve. VIEW YOUR SBC. Some medications may have limits on how many doses are paid for by your policy. _____ _____ Enrollee Signature Date _____ _____ Independent Producer’s Name Blue Cross # Form No. Sales Guide; Outline of Coverage (includes monthly premium rates) Application; 2021 Monthly Premium Rates Please have your Blue Cross of Idaho member ID available. In addition, some employer groups may choose to purchase enhanced coverage for preventive drugs. Please fill in all of … Follow the additional prompts to complete a Cost & Coverage check. 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. Medical Policy Library Table of Contents : Section Mental Health: Original Policy Date October 2015 : Disclaimer. Write Blue Cross of Idaho Care Plus, P.O. Find a provider in your area! Please click the button below to access your benefits. No Remove. Blue Cross of Idaho administers COBRA coverage for state of Idaho group members. 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. Here are a few items to keep in mind as you choose the plan that is best for you. Although generic drugs are chemically the same as their branded counterparts, they are typically sold at substantial discounts from the branded price. Sign on and check your benefits today! This plan includes additional Medicare prescription drug (Part-D) coverage. Do you have more than one health insurance plan? The policies are used for the express purpose of assisting physicians and other healthcare providers in providing evidence based cost effective care. 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. Healthy Smiles also uses Blue Cross of Idaho’s preferred provider organization (PPO) network of over 900 dentists and other dental providers in Idaho, … Receipt of benefits is subject to satisfaction of all terms and conditions of the coverage. Set up your Blue Cross of Idaho member portal login at members.bcidaho.com.. Sort by Facility or City. 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. (Check your summary of benefits and coverage to see the list of covered vaccines for your plan.). You can learn more about cost-sharing, coverage limitations, and if you need a referral to see a specialist. These benefits include coverage of self-administered medications, as well as some vaccines and specialty medications. Most employer groups use one of three formularies. 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 True Blue Rx Preferred (HMO) plan has a $150 drug deductible. Blue Cross of Idaho’s commitment to that is unchanging in these unprecedented times. 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. 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). Be sure to read the "exclusions and limitations" in the 2020 Short Term PPO Brochure before buying a plan. * Please Select Your County: * First Name * Last Name * Date of Birth * Tobacco User? Start a file for your FY2021 receipts. Blue Cross of Idaho … The medical policies contained in this manual are the property of Blue Cross of Idaho. Some, but not all ACA drugs are listed in the formularies. 2. 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 … 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. POWERED BY BLUE CROSS OF IDAHO CARE PLUS, INC 3 . Please enter a valid Zip Code. Deductible. Fax 1-208-387-6811 You may contact us by fax for expedited coverage decisions. There is an individual deductible of $50 per member per benefit period. Your benefits description contains useful information about the services covered by your plan for the current benefit period. Blue Cross of Idaho's Short Term PPO sm offers a limited benefit program for temporary coverage. Select Check Drug Cost & Coverage from the Plan & Benefits menu. Blue Cross of Idaho Rx offers comprehensive pharmacy benefits for many of our members. But if you want to, you can also use … SUMMARY OF BENEFITS POWERED BY BLUE CROSS OF IDAHO CARE PLUS, INC Which doctors and hospitals can I use? Rate card: (11/01/2020 through 01/31/2021) Rate card: (02/01/2021 through 04/30/2021) Each Healthy Smile plan has something unique to offer. Maybe you’re ready to start a family or are just starting to give it some thought. Preventive care generally does not include medications prescribed for treatment of an existing illness or condition. This is a 4.5-star Medicare Advantage plan. 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. True Dental Complete: Full preventive and comprehensive dental coverage. About Blue Cross of Idaho / Contact; Code of Ethical Business Conduct / Nondiscrimination Notice and Language Assistance; Powered by Blue Cross of Idaho Care Plus, Inc. Blue Cross of Idaho Care Plus, Inc. is a Medicare Advantage plan with a Medicare contract. 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. If you're looking to make a change, you may save money by staying blue. Quantity Limits for Commercial and Qualified Health Plans are included in the formulary. Find plans that bring peace of mind to you and your family. Medical policies consist of medical guidelines, including diagnostic imaging management policies, payment guidelines and evidence-based guidelines. Write Blue Cross of Idaho Care Plus, P.O. 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. You can search other benefit periods to review previous benefit descriptions. 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. Additionally, coordinating your benefits helps us process your claims faster and maximizes your benefits, which can lower your out-of-pocket costs. 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