Blue Care Network Geared perfectly for your needs. Enroll by calling Retiree Health Care Connect (contact information inside)

Transcription

1 Blue Care Network Geared perfectly for your needs Enroll by calling Retiree Health Care Connect (contact information inside)

2 November 2011 Dear UAW Trust Member: The UAW Retiree Medical Benefits Trust (the Trust ) provides health care benefits for UAW Auto retirees and their dependents. In 2012, the Trust will continue to work with Blue Care Network of Michigan (BCN) to offer an additional health plan choice to you. You may remain with your current health plan or choose a new plan the choice is yours. This material contains detailed information on the benefits of this plan. Here are a few key points to keep in mind: Your monthly contributions to the Trust remain the same, regardless of the plan you are enrolled in. Your current providers may not be a part of BCN s network. It is important to check if your providers are in BCN s network before changing from your current plan. Reduced costs compared to the Blue Cross Blue Shield Traditional Care Network plan: No deductibles or coinsurance Unlimited office visits are covered with a $25 copay, including specialists Additional wellness programs and discounts Your prescription drug coverage will be transferred from Medco to BCN Your prescription drug cost share will remain the same as the Traditional Care Network but some prescriptions may be classified differently by BCN, which may result in different cost share amounts. You can call Blue Care Network s customer service center to discuss any questions or concerns you may have. The contact information is in the enclosed material. The choice to enroll in a new plan is entirely up to you. If you do not wish to enroll in a new plan, no action is required. You may call Retiree Health Care Connect (RHCC) to enroll. GM / Chrysler Trust members: Ford Trust members: Plan changes will become effective the first day of the second month following your change request, no earlier than January 1, Sincerely,

3 1 Always in motion for a healthier Michigan Blue Cross Blue Shield of Michigan has called this great state home for more than 70 years. As the state s largest health insurer, we feel a unique responsibility to help improve the health of all Michigan citizens. We take that job seriously. We design and support activities that make a real and lasting difference in people s lives. We partner with physicians, hospitals and our customers to improve the quality of health care while bringing down costs. Blue Care Network is Blue Cross Blue Shield of Michigan s health maintenance organization subsidiary. We offer the quality medical benefits people expect from Michigan s most trusted name in health care. We give members access to a large provider network and a single point of contact for care a BCN primary care physician is a member s health care partner and coordinates all care. To choose Blue Care Network coverage, call Retiree Health Care Connect. MiBCN.com/URMBT

4 2 One amazing card for you Great medical benefits Exceptional health and wellness support Worldwide recognition of the blue cross and shield Valuable online tools to help you take charge of your health Discounts on health and fitness services Coverage of preventive services such as immunizations, wellness checks and important health screenings $25 copayment on unlimited office visits (see benefit chart on Pages 6-9) Our network doctors accept our payments as payment in full. You pay only your copay. We can help sharpen your vision NEW A routine eye exam every 12 months 20 percent member discount on glasses For details, call VSP Vision Care at Or, go online to vsp.com.* *Blue Care Network does not control this website or endorse its general content.

5 3 We offer easy access As the state s largest HMO, our robust provider networks make it easy to find a doctor or hospital that takes your coverage: 4,700 primary care physicians 13,500 specialists Most of the state s leading hospitals To find a BCN doctor, go to MiBCN.com/find or call BCN Customer Service at or (TTY) from 8 a.m. to 5:30 p.m. Monday through Friday. If illness slows you, we ll help If you have asthma, diabetes, congestive heart failure or other chronic conditions, turn to us for ongoing support. Nurse case managers will work with you when you re sick. We re just a call away Health care educators are just a phone call away to answer your questions about high blood pressure, cholesterol, weight and stress, plus much more. We ve gone mobile Like to have information on the go? Members can register on bcbsm.com and then click to health plan details on smart phones or other smart mobile devices. MiBCN.com/URMBT

6 4 Save money, stay healthy, get fit Use your ID card to unlock big savings with our revolutionary Healthy Blue Xtras SM savings program. Get discounts on products and services that can help you live a healthier lifestyle. We ve got savings on everything from diet plans to fitness centers, grocery stores to relaxing getaways and fitness equipment to medical emergency jewelry. Members can go online to view the special discounts just for them. Offers are available from more than 50 Michigan-based companies, encouraging members to buy local and contribute to the Michigan economy. In addition, almost 30 offers are from national companies through our national savings program, Blue365. Our card travels with you that s peace of mind Whether you re vacationing up north or down south, Blue Care Network coverage travels with you. And with your dependents, too. No other card is as recognized and accepted as the one that carries the blue cross and shield. Our card gives you access to thousands of hospitals and doctors across the U.S. who participate with Blue plans. Around the world in 200 countries and territories, get emergency care at BlueCard hospitals. BlueCard is a Blue Cross and Blue Shield Association program that gives Michigan Blues members access to out-of-state Blue plans.

7 5 We mesh perfectly with pharmacies Blue Care Network ID cards are accepted at thousands of pharmacies nationwide, including most major chains. For maintenance drugs, you have the choice of mail order or retail pharmacies. Moving for the winter? We have you covered. Coordinate care away from home with your Blue Care Network primary care physician before you go. Our network s always growing We re signing up more and more doctors for you to see. Check your choices at MiBCN.com/find. MiBCN.com/URMBT

8 Blue Care Network benefits at a glance Physician office services Routine office visits Consulting specialist care (when referred) Periodic physical exam Routine pediatric care Annual gynecological exam $25 copay per visit $25 copay per visit $25 copay per visit $25 copay per visit $25 copay per visit Preventive services Vision exam VSP Vision Care: , vsp.com Immunization pediatric and adult Mammography screening Pap smears Prostate Specific Antigen (PSA) screening laboratory services only $25 copay covered once every 12 months ; office visit copay may apply ; office visit copay may apply ; office visit copay may apply Diagnostic and therapeutic procedures Laboratory tests Diagnostic X-rays Radiation therapy ; office visit copay may apply ; office visit copay may apply ; office visit copay may apply

9 7 Maternity services provided by physician Prenatal and postnatal care Delivery in hospital and well-baby care in hospital $25 copay per visit Hospital care (inpatient/outpatient) Number of days of care In-hospital physician care, general nursing care, surgery (including all related surgical services, anesthesia, lab, X-rays and drugs) Outpatient facility services Unlimited Emergency medical care* Hospital emergency room (copay waived if admitted as an inpatient) Urgent care facility Ambulance services $100 copay per visit $ 50 copay per visit ground and air service *Ford Protected: $0 copay for emergency room and urgent care Mental health care Outpatient visits Inpatient psychiatric hospital services Contact plan for specific copayments up to 45 days, per calendar year, renewable after 60 days of nonconfinement. BCN 65 SM **:, 45 additional days of inpatient mental health, renewable after 60 days of discharge once the 190 days covered under Medicare are exhausted or the intermediate substance abuse covered under the certificate is exhausted. ** BCN 65 is a Blue Care Network plan for individuals who are at least age 65, enrolled in Medicare Parts A and B and live in an eligible Michigan area. For details, go to MiBCN.com/URMBT or call BCN Customer Service at or (TTY). continued on Page 8 MiBCN.com/URMBT

10 Blue Care Network benefits at a glance continued from Page 7 Alcoholism and substance abuse services Outpatient visits for crisis intervention and short-term therapy Intermediate care (intermediate days combined with inpatient mental health) Detoxification Up to 35 visits per year, covered in full up to 45 days per calendar year, renewable after 60 days of nonconfinement. BCN 65: ; 45 additional days of intermediate substance abuse care, renewable after 60 days of discharge once the 190 days covered under Medicare are exhausted or the intermediate substance abuse covered under the certificate is exhausted. Skilled nursing care Skilled nursing facility care Nursing services in the home (when medically necessary) Home health care (when medically necessary) Hospice care 100 days renewable after 60 days of nonconfinement

11 9 Other services Prosthetics, orthotics and corrective appliance (when medically necessary) Vasectomies, tubal ligations Infertility treatment Durable medical equipment (when medically necessary) Allergy testing, evaluation and serum Allergy injections Physical therapy: 60 treatments per condition per year Hearing aid hearing examination and aid covered once each 36 months ; office visit copay may apply Not covered exclusion includes in-vitro fertilization, artificial insemination and infertility drugs ; office visit copay may apply ; office visit copay may apply limited to 60 visits per medical episode, per plan year. BCN 65: Limit is based on Medicare guidelines. binaural hearing aids every 36 months, if younger than 19 Pharmacy Retail and mail order prescription drug copay including contraceptives; 1-30 day supply Retail prescription drug copay including contraceptives; day supply Mail-order prescription drug copay including contraceptives; day supply Generic $10 copay Preferred brand $30 copay Nonpreferred brand $80 copay Generic $20 copay Preferred brand $60 copay Nonpreferred brand $160 copay Generic $20 copay Preferred brand $60 copay Nonpreferred brand $160 copay Exclusions Coverage for erectile dysfunction medications (e.g., Viagra, Cialis, Levitra, Staxyn ), except in prior authorized cases of pulmonary arterial hypertension. Coverage for proton pump inhibitor drug class (e.g., omeprazole, Prilosec, Zegerid, Nexium, Aciphex, Prevacid, Protonix ), except in prior authorized cases of Barrett s esophagitis and Zollinger-Ellison syndrome. MiBCN.com/URMBT

12 10 Just a call gets the wheels turning Enroll or ask questions about coverage by calling Retiree Health Care Connect. To make BCN your plan starting January 1, you ll need to enroll by November 30. We re working hard to be your partner in health care If you ve been a Blue Cross Blue Shield of Michigan member, we want you to stay with the brand you know and trust. Exceptional customer service is available to you face-to-face, by phone and at MiBCN.com. We ll help you make the most of your health when you re well and when you re ill.

13 11 Retiree Health Care Connect GM / Chrysler Trust members: Ford Trust members: Blue Care Network Customer Service or (TTY) 8 a.m. to 8 p.m., Monday through Friday MiBCN.com/URMBT

14 Presorted FIRST CLASS MAIL US Postage Paid 600 E. Lafayette Blvd. Detroit, MI Blue Cross Blue Shield of Michigan MiBCN.com/URMBT UAWStrong As a Michigan-based plan, we ve been involved with the auto industry for many years. We ve worked with the UAW Retiree Medical Benefits Trust since its creation to provide high quality, member-friendly coverage. With more than 2,000 UAW-represented staff members, we proudly serve more than 1.1 million autoworkers, retirees and their family members. All of us at Blue Cross Blue Shield of Michigan and Blue Care Network work together to provide quality, affordable care. For BCN coverage, call Retiree Health Care Connect. See numbers inside. CB OCT STCM