For fast (expedited) coverage decisions, call the same number at 1-888-494-2583 (TTY 711). Although generic drugs are chemically the same as their branded counterparts, they are typically sold at substantial discounts from the branded price. The Blue Cross of Idaho formularies list drugs approved for coverage under your policy. These benefits include coverage of self-administered medications, as well as some vaccines and specialty medications. *Not included with the True Blue Rx Essentials plan. 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. You have the option to choose a brand-name medication when a generic equivalent exists. Once you have Medicare Part A and Part B, you can enroll in a Idaho MedPlus Medicare Supplement plan. Terms and Conditions × The following Terms and Conditions govern your use of the Blue Cross of Idaho on-line application. This is a 4.5-star Medicare Advantage plan. True Blue Rx Essentials members have a $3,000 coverage limit. 4 SUMMARY OF 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. 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 At Blue Cross of Idaho, we understand Idahoans must have options for affordable healthcare coverage, with the financial peace of mind they deserve. Write Blue Cross of Idaho Care Plus, P.O. In addition to the tiers, certain preventive drugs may be covered at no cost. Medical technology is constantly changing and we reserve the right to review and update our policies periodically. This option allows you to purchase Blue Cross of Idaho medical and dental coverage without interaction with the Your Health Idaho Exchange. Active Policy. 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. To locate a participating pharmacy, visit our Pharmacy Locator. Start a file for your FY2021 receipts. Your benefits description contains useful information about the services covered by your plan for the current benefit period. 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. If you are unsure about the formulary your plan uses, please contact CVS Caremark RX Customer Care at the number on the back of your Blue Cross of Idaho member ID card to check costs for prescription drugs. Plan brochure. We offer affordable choices that: Write Blue Cross of Idaho Care Plus, P.O. Blue Cross of Idaho’s Summary of Benefits and Coverage (SBC) provides detailed information about your health coverage options and benefits. 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. Prior authorization is the process of determining medical necessity for a nonemergency medical service or procedure. 2. 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. 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. SUMMARY OF BENEFITS POWERED BY BLUE CROSS OF IDAHO CARE PLUS, INC Which doctors and hospitals can I use? *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. The Blue Cross of Idaho formularies list drugs approved for coverage under your policy. Box 7408 Boise, ID 83707. Here are a few items to keep in mind as you choose the plan that is best for you. At Blue Cross of Idaho, we understand Idahoans must have options for affordable healthcare coverage, with the financial peace of mind they deserve. 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. Costs are lowest for first tier (generic) drugs, and costs increase as the tiers increase. Preventive Services. Please have your Blue Cross of Idaho member ID available. * Please Select Your County: * First Name * Last Name * Date of Birth * Tobacco User? Receipt of benefits is subject to satisfaction of all terms and conditions of the coverage. Blue Cross of Idaho's Short Term PPO sm offers a limited benefit program for temporary coverage. Medical Policy Library Table of Contents : Section Mental Health: Original Policy Date October 2015 : Disclaimer. Most employer groups use one of three formularies. TRUE BLUE RX (HMO) TRUE BLUE RX (HMO) HEALTHY SMILES PLUS COMPREHENSIVE COVERAGE FOR PREVENTIVE AND BASIC DENTAL SERVICES Your teeth are important indicators of your overall health, which is why Blue Cross of Idaho gladly offers additional dental coverage you can add into your Medicare Advantage plan for only $23.60 more a month. 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. Sort by Facility or City. Select Benefits and Coverage from the Prescription Drugs menu. 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. Secure Blue no Rx has a network of doctors, hospitals and other providers. Blue Cross of Idaho’s Summary of Benefits and Coverage (SBC) provides detailed information about your health coverage options and benefits. Receipt of benefits is subject to satisfaction of all terms and conditions of the coverage. Follow the additional prompts to complete a Cost & Coverage check. Contact your insurange agent or Blue Cross of Idaho account representative to find an affordable health coverage option for your business. Secure Blue Plan Premium Table. Box 8406, Boise, ID 83707 Blue Cross of Idaho offers coverage for mammogram screenings. True Blue HMO is a sound approach to good health, with the convenience of services from one of the largest provider networks in Idaho. Please fill in all of … Protect yourself from the coverage gaps in Original Medicare and live healthier with our Medicare Advantage plans. Discover the benefits you want with the affordable coverage you … But if you want to, you can also use … You must be logged-in to view this page. Please click the button below to access your benefits. N/A; Retired Policy Versions. You can also contact us to ask for a coverage decision before you receive certain medical services. Please enter a valid Zip Code. 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. Refer to the Blue Cross of Idaho Care Plus, Inc. Summary of Benefits for more information. You can learn more about cost-sharing, coverage limitations, and if you need a referral to see a specialist. MP 7.01.47 - Bariatric Surgery - Effective 02/19/2020 ... About Blue Cross of Idaho / 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. 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. 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. MEDICARE. There is an individual deductible of $50 per member per benefit period. 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. Any time, day or night, you can speak with a registered nurse at no cost to you. If so, those plans need to work together to make sure you’re getting the most out of your coverage. This is a 3.5-star Medicare Advantage plan. If this is the first time you are visiting CVS Caremark, you will be asked to register. Fax 1-208-387-6811 You may contact us by fax for expedited coverage decisions. However, the insured could be financially responsible for services found to be not medically necessary when provided by a noncontracting provider. Some medications may have limits on how many doses are paid for by your policy. *A benefit period is the 12 months following your coverage effective date. Healthy Smiles also uses Blue Cross of Idaho’s preferred provider organization (PPO) network of over 900 dentists and other dental providers in Idaho, … If you would like to know more about Specialty medications, please visit the Specialty Drugs page. MERIDIAN — Blue Cross of Idaho has waived all member cost-sharing for testing and treatment of COVID-19, the company announced Thursday. 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) This option does not allow you to take advantage of either your subsidy or possible catastrophic benefit. 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. Your Benefits “To-Do” List. payment to your local Blue Cross of Idaho district office (listed on the back of this brochure). Plus, knowing what’s covered saves you money! Blue Cross of Idaho Rx offers comprehensive pharmacy benefits for many of our members. If you use the providers in our network, you may pay less for your covered services. Blue Cross of Idaho partners with IngenioRx to provide pharmacy benefits to most of our membership. Drugs are categorized into benefit levels, also known as tiers, which determine the amount you pay. 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. 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. 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. This is a 3.5-star Medicare Advantage plan. 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. FY2021 COBRA Premium Rate (Start July 1) FY2021 COBRA Rates – MEDICAL The formularies also provide information regarding the following: Most employer groups use one of three formularies. Box 8406, Boise, ID 83707 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 … We are dedicated to serving our members and the Idaho community. Sort by Facility or City. Call (800) 704-0727to ask questions about your prescriptions, finding a doctor or specialist, or understanding a health condition. You must be logged-in to view this page. Details Drug Coverage for the Blue Cross of Idaho True Blue Rx Gem H1350-024 (HMO) in Idaho. With expanded benefits and low copays, Blue Cross of Idaho CarePlus Inc.’s Medicare Advantage plans offer more value than ever. 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). Medical policies consist of medical guidelines, including diagnostic imaging management policies, payment guidelines and evidence-based guidelines. Select Benefits and Coverage from the Prescription Drugs menu. No Remove. Details Drug Coverage for the Blue Cross of Idaho True Blue Rx Preferred H1350-021 (HMO) in Idaho. 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. 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. Generic drugs are equivalent to brand-name drugs in dosage, safety, strength, route of administration, quality, performance characteristics and intended use. 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. 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 . Last Updated 10/9/2020. This is a 3.5-star Medicare Advantage plan. Pre-pregnancy. Additionally, coordinating your benefits helps us process your claims faster and maximizes your benefits, which can lower your out-of-pocket costs. 2020 Evidence of Coverage for Blue Cross Idaho Medicaid Plus 5 Chapter 1. Please enter a valid Zip Code. 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 … The Preventive Drug List (2020 and 2021) provides a list of medications covered under the preventive drug benefit . Blue Cross of Idaho provides health insurance, dental insurance, and medicare advantage coverage to the residents of Idaho. 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 – Blue Cross of Idaho gives you six different exam and hardware allowance plans to choose from. (Check your summary of benefits and coverage to see the list of covered vaccines for your plan.). 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 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. 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. This plan includes additional Medicare prescription drug (Part-D) coverage. You must be logged-in to view this page. 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