0000010126 00000 n Learn more about BCBS FEP Dental plan benefits and premiums. Need help understanding and choosing a benefit plan? These services are covered 12 months after you first join a Blue Dental plan. BlueCare Dental Choice PPO - This is known as an active plan design. Questions? Does Blue Cross and blue shield of Texas (bcbstx) have a dental Wellness Center? BlueCard applies if the provider of service is outside the member's Blue Cross Blue Shield Plan's service area and does not contract with the member's Plan. Our BlueCare DentalSM program offers two network-based dental products. 0000139581 00000 n Unfortunately, Medicaid does not cover cosmetic dentistry procedures like veneers. Services may be provided from a single site or from multiple locations. 0000006903 00000 n See specialty health maintenance organization. Individuals attempting unauthorized access will be prosecuted. Contact Pacific Blue Cross for more information or to speak with one of our Service Representatives: Individual Plans Sales and Support Telephone: 604 419 2000 Fax: 604 419 2199 Email: inhealth@pac.bluecross.ca Toll-free Outside the Greater Vancouver Area: An employer that has offices or branches in more than one location, but offers uniform healthcare coverage of benefits to all of its employees. 0000028804 00000 n You pay 50% after deductible before meeting your out-of-pocket max, and $0 after meeting your out-of-pocket max. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. There is a deductible for Class II and III services only. 0000014575 00000 n Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: 01/01/2022- 12/31/2022 Anthem Blue Cross: PORAC Prudent Buyer PPO Plan Coverage for: Individual + Family | Plan Type: PPO CA/L/A/CalPERS PPOC20800:PORACPrudentBuy-PPO/NA/UQBHJ/NA/01-22 1 Limited to twice a year in combination with routine cleaning. Identification cards issued by a pharmacy benefit management plan (PBM) to plan members. BCBS FEP Dental has nearly half a million provider access points nationwide to receive in-network services, a customer service team dedicated to exceeding your expectations, online tools to make your life easier, and a variety of options and benefits to meet your needs. What are the side effects of Thiazolidnedions. You pay50% after deductible before meeting your out-of-pocket max, and $0 after meeting your out-of-pocket max. The three dental plans for children on Medicaid are: Dentaquest, MCNA Dental and UnitedHealthcare Dental. A health maintenance organization (HMO) that contracts with a group of physicians with multiple specialties who are employees of the group practice. endstream endobj 8 0 obj <> endobj 6129 0 obj <> endobj 6130 0 obj <> endobj 838 0 obj <> endobj 2595 0 obj <>/K 1115 0 R/ParentTree 2597 0 R/ParentTreeNextKey 138/RoleMap 2695 0 R/Type/StructTreeRoot>> endobj 2596 0 obj <>/A0+1<>/A0_1<>/A1<>/A1+1<>/A1+2<>/A10<>/A10+1<>/A10_1<>/A11<>/A11+1<>/A11_1<>/A12<>/A12+1<>/A12+2<>/A12_1<>/A13<>/A13+1<>/A14<>/A15<>/A17<>/A2<>/A2+1<>/A2+2<>/A20<>/A3<>/A3+1<>/A4<>/A4+1<>/A4_1<>/A5<>/A5+1<>/A5_1<>/A6<>/A6+1<>/A6_1<>/A7<>/A7_1<>/A8<>/A8+1<>/A9<>/CM1<>/CM1+1<>/CM1+2<>/CM1+3<>/CM10<>/CM10+1<>/CM10+2<>/CM10+3<>/CM11<>/CM11+1<>/CM11+2<>/CM11+3<>/CM12<>/CM12+1<>/CM12+2<>/CM12+3<>/CM13<>/CM13+1<>/CM13+2<>/CM14<>/CM14+1<>/CM14+2<>/CM15<>/CM15+1<>/CM16<>/CM16+1<>/CM17<>/CM18<>/CM2<>/CM2+1<>/CM2+2<>/CM2+3<>/CM3<>/CM3+1<>/CM3+2<>/CM3+3<>/CM4<>/CM4+1<>/CM4+2<>/CM4+3<>/CM5<>/CM5+1<>/CM5+2<>/CM5+3<>/CM6<>/CM6+1<>/CM6+2<>/CM6+3<>/CM7<>/CM7+1<>/CM7+2<>/CM7+3<>/CM8<>/CM8+1<>/CM8+2<>/CM8+3<>/CM9<>/CM9+1<>/CM9+2<>/CM9+3<>/Pa0<>/Pa0+1<>/Pa0_1<>/Pa1<>/Pa1+1<>/Pa10<>/Pa10+1<>/Pa10_1<>/Pa11<>/Pa11+1<>/Pa11+2<>/Pa11_1<>/Pa12<>/Pa12+1<>/Pa12_1<>/Pa13<>/Pa13_1<>/Pa14<>/Pa14_1<>/Pa15<>/Pa15+1<>/Pa16<>/Pa16+1<>/Pa16_1<>/Pa17<>/Pa17_1<>/Pa18<>/Pa18_1<>/Pa19<>/Pa19_1<>/Pa2<>/Pa2+1<>/Pa20<>/Pa21<>/Pa21_1<>/Pa24<>/Pa25<>/Pa26<>/Pa28<>/Pa3<>/Pa3+1<>/Pa30<>/Pa4<>/Pa4+1<>/Pa5<>/Pa5+1<>/Pa5+2<>/Pa6<>/Pa6+1<>/Pa6_1<>/Pa7<>/Pa7+1<>/Pa7+2<>/Pa7_1<>/Pa8<>/Pa8_1<>/Pa9<>/Pa9+1<>/Pa9_1<>>> endobj 1115 0 obj <> endobj 2597 0 obj <><>]>> endobj 2695 0 obj <> endobj 2132 0 obj <>1036]/P 2131 0 R/Pg 997 0 R/S/Link>> endobj 2077 0 obj <>991]/P 2076 0 R/Pg 987 0 R/S/Link>> endobj 2033 0 obj <>990]/P 2031 0 R/Pg 987 0 R/S/Link>> endobj 2061 0 obj <>988]/P 2060 0 R/Pg 987 0 R/S/Link>> endobj 2212 0 obj <><>]/P 2211 0 R/Pg 972 0 R/S/P>> endobj 2580 0 obj <>1240]/P 2579 0 R/Pg 1008 0 R/S/Link>> endobj 1244 0 obj <>280 281 282]/P 1243 0 R/Pg 927 0 R/S/Link>> endobj 1242 0 obj <>263 264]/P 1241 0 R/Pg 927 0 R/S/Link>> endobj 1223 0 obj <>255 256 257]/P 1222 0 R/Pg 927 0 R/S/Link>> endobj 1211 0 obj <>167 168 169]/P 1210 0 R/Pg 910 0 R/S/Link>> endobj 1160 0 obj <>73]/P 1159 0 R/Pg 849 0 R/S/Link>> endobj 1159 0 obj <> endobj 849 0 obj <. 0000050349 00000 n The process of identifying and classifying the risk represented by an individual or group. 0000069156 00000 n 0000039957 00000 n Enables members to receive healthcare services wherever they live or travel, nationally or internationally. Plan Type: PDENT BlueCare Dental Connection Take Advantage of Dental and Discount Programs As a valued member, you have access to a variety of tools and resources to help you and your loved ones manage your oral health and save money through our discount programs. 0000005103 00000 n Not registered? 0000010545 00000 n Blue ShieldFEP Dental's value and offerings. There is no need to submit a paper claim. Register Now, Not registered? Thats why Blue Cross and Blue Shield of Texas created BlueCare Dental Connection. takes the health and well-being of our members, providers, our associates and our business partners seriously. 0000010274 00000 n 0000050040 00000 n The Medicare component that provides benefits to cover the costs of physicians' professional services, whether the services are provided in a hospital, a physician's office, an extended-care facility, a nursing home or an insured's home. Accounts that employers can establish for employees to reimburse a portion of their eligible family members' out-of-pocket medical expenses, such as deductibles, coinsurance and pharmacy expenses. 0000006015 00000 n 0000024004 00000 n Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Preventive care programs designed to monitor and promote the administration of vaccines to guard against childhood illnesses, such as chicken pox, mumps and measles, as well as adult illnesses, such as pneumonia and influenza. Many people losing their Medicaid coverage will be eligible for financial help to pay for healthcare and some could be eligible for a $0 monthly premium plan. Covered once per tooth per lifetime. Download a paper application and email to help@ihealthagents.com or fax to 847-220-9280. 0000088308 00000 n 0000070270 00000 n A toll-free number, 1-800-810-BLUE, that members can use to locate providers in another Blue Cross Blue Shield company's area. See also precertification. The examples are meant to help you understand what you might pay, and compare that to other plans. 0000075858 00000 n The name Affordable Care Act refers to the final, amended version of the law. A process through which an organization validates credentialing information from the organization that originally conferred or issued the credentialing element to the practitioner. Also known as a fee allowance, fee maximum or capped fee. Root canals 100% coverage for periodontal cleanings to members with specific health issues at no additional cost. A federal law that outlines the requirements that employer-sponsored group insurance plans, insurance companies and managed care organizations must satisfy in order to provide health insurance coverage to individuals and groups. A medical care center that provides a wide range of healthcare services, including preventive care, acute care, surgery and outpatient care, in a centralized facility. PDF File is in portable document format (PDF). Often the patient and the indirect care provider are in different physical locations. It is often proven by eliminating other diseases and possibilities. Blue Cross MedicareRx SM Attn: Medicare D Clinical Review . %?Mf_A_a_A_a_A_a_A_e_E_YpV:+ premium table below. 44 79 Get access to your online account. Get access to your online account.Register Now, Not registered? It includes such information contained in any form or medium (electronic, paper, oral, etc.). The Pacific Blue Cross Mobile app helps you manage your benefits and improve the health & wellbeing of you and your family. Scroll. IyaPC96>$i}KFVLWEs$g;iQrij:J]#b]Fd`0c;TU\5ZXyZbb{l I6Be6i^f+viqy .px8~N Dental PPO can be purchased as a stand-alone dental product or in conjunction with dental HMO. The services covered include: Teeth cleanings. Copyright 2022Health Care Service Corporation. 2020-09-09T21:17:19-07:00 BlueCare Dental Connections SM Research shows there may be a link between oral health and illnesses like heart disease, stroke, diabetes and premature birth. If you're considering enrolling in one of our individual and family plans, learn a bit more about the coverage you'll receive. Check out our FAQs page to get answers to questions, or Contact Us with any questions you may have. The site may also contain non-Medicare related information. A Medicare supplement that uses a preferred provider organization (PPO) to supplement Medicare Part B coverage. 0000107898 00000 n Refers to any Blue Cross and/or Blue Shield Plan. +3. 0000013821 00000 n A large pool of individuals for which health coverage is provided by the group sponsor. Periodontal maintenance Find a planto get a quote. Not Registered? The BlueCare Dental PPO product is a product available for purchase on a self-funded basis only. 0000002318 00000 n Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. Bridges and dentures gYpV:+ A company that is owned by its members or policyowners. This all-ages dental plan covers 100 percent of preventive services like exams and cleanings when you see a Tier 1 PPO in-network dentist, and also helps cover care when you see a dentist who isnt in our preferred network. The broad range of activities that an MCO and its employees undertake to support the delivery of the promised benefits to members and ensure member satisfaction. Preventive care like exams and cleanings. Learn more about dental services for adult STAR members. Cleanings are covered three times a year. <<73BE20F0500195428ED66B90D75311C9>]/Prev 113554>> 0000074942 00000 n Healthcare services that are generally considered outside standard medical-surgical services because of the specialized knowledge required for service delivery and management. One option is Adobe Reader which has a built-in reader. Up to $800 of the $1,200 in-network total can be used toward out-of-network care. 0000041910 00000 n HTF>QP13V2Y!QLS=k *Bl~DF*iU&!Tg))a,py7!-p{&1 !$=^S2`;bFp: v}-+OJ9bx0%M{ih,,D-O4oF$>N-fbh gj]N^|w&r~XF#81e{Ta33=gKI. BlueCare Dental is a portfolio of standard dental preferred provider option (PPO) benefit plan designs BlueCare Dental Freedom SM and BlueCare Dental Choice SM. Get access to your agent portal.Register Now. Alberta. A toll-free number, 1-800-676-BLUE, for healthcare providers to verify Blue Cross Blue Shield membership and coverage information for patients. The PPO dental plan provides a higher level of benefits when members receive treatment from BlueCare Dental participating providers. This includes services the doctor provides and other services your child might need like anesthesia. Call us at (312) 726-6565 Benefits & Rates Log in and look. by: Nichole Niemann. Is your health coverage changing. BlueCare Dental ConnectionSM is a program benefit that provides members with education and intervention through support tools and educational mailings. These services are covered six months after you first join a Blue Dental plan. Members choose in-network care or out-of-network care at the time they make their dental appointment and usually incur higher out-of-pocket costs for out-of-network care. PII, as used in these Inter-Plan Programs Policies and Provisions, may have other meanings as assigned by various state laws related to data security breach notification. 0000009905 00000 n We provide health insurance in Michigan. 0000029289 00000 n Treatment that is provided to a patient who is able to return home after care without an overnight stay in a hospital or other inpatient facility. Established by the Balanced Budget Act, this program is designed to provide health assistance to uninsured, low-income children either through separate programs or through expanded eligibility under state Medicaid programs. Refer to this list for drug coverage information for Blue Cross members whose plan uses the Custom Select Drug List. Limited to once every 24 months for primary teeth, and once every 48 months for permanent teeth. Blue Access for Members SM(BAM SM) The gateway to help manage your personal health information. 2023 BlueCare Dental PPOSM (Mid-Market) Plans, Health Care Fraud Prevention and Reporting, Texas Six (6) Month State Continuation of Coverage (Post COBRA), 2023BlueCare Dental PPO (Small Group) Plans, 2022BlueCare Dental PPO (Small Group) Plans, 2023BlueCare Dental PPO (Mid-Market) Plans, 2021BlueCare Dental PPO (Mid-Market) Plans, 2021BlueCare Dental PPO (Mid-Market) Plans - Spanish, They will receive the higher level of benefits (In-Network Benefits), They are not required to file claim forms Network providers bill Blue Cross and Blue Shield of Texas (BCBSTX) for services provided. 0000075153 00000 n Oral health touches every aspect of our lives but is often taken for granted. %%EOF However, the lower benefit plan level will apply and out-of-pocket expenses will be higher when receiving dental services from dentists not in the BlueCare DentalSM network. For travellers, the app is the fastest way to buy and manage Canada's most trusted brand in travel insurance. Ue-f}zM^+r5{dV9KfK.K.K.#Q6zzz=^W+kta8e6E6e6Eldtdx$LNp9- endstream endobj 27 0 obj <> endobj 28 0 obj <>stream Most PDF readers are a free download. But you'll pay less if you see a Tier 1 PPOin-network dentist. 0000041603 00000 n Also known as a chief medical officer. Understanding your Blue Cross Blue Shield FEP Dental coverage is the key to making the most of your benefits, keeping your smile healthy and protecting your overall health. Includes coordination of benefits, Workers' Compensation, subrogation and no-fault auto insurance. A coordinated system of preventive, diagnostic and therapeutic measures intended to provide cost-effective, quality healthcare for a patient population who have or are at risk for a specific chronic illness or medical condition. Once you have identified your rating area, you can view premium amounts for our available plans in the Allows members to save money into tax-advantaged accounts. 0000003587 00000 n 0000076164 00000 n 0000047395 00000 n After reaching that limit for the year, you pay for 100% of your dental care. All Canada. Auxiliary or supplemental services, such as diagnostic services, home health services, physical therapy and occupational therapy, used to support diagnosis and treatment of a patient's condition. The three characters preceding the subscriber identification number on BCBS member ID cards. 0000009079 00000 n 0000001675 00000 n We will cover all overseas services at the in-network level for all members. 0000115092 00000 n 0000015769 00000 n Blue Cross and Blue Shield of Oklahoma (BCBSOK) is providing access to the Dental Wellness Center website as a courtesy, as part of its BlueCare Dental Connection program. 0000036033 00000 n HealthEquity is our business associate and is an independent company that provides account-based plan services to Blue Cross. Blue Cross Blue Shield awards this designation to medical facilities that have demonstrated expertise in delivering quality healthcare in the areas of: bariatric surgery, cardiac care, complex and rare cancers, spine surgery, transplants and knee and hip replacement. Oral surgery When you partner with Blue Cross Blue Shield of Michigan, you're selecting the strongest network of providers in Michigan. An agreement with a provider not to bill the subscriber for any difference between billed charges for covered services (excluding coinsurance) and the amount the provider has contractually agreed with a Blue Cross Blue Shield company as full payment for those services. Federal Programs. Most PDF readers are a free download. BCBSIL and go2dental.com are separate companies. In addition, some sites may require you to agree to their terms of use and privacy policy. This is the limit on what your plan pays for dental care benefits for members who are 19 or older when their plan starts. Any additional costs are paid by the member out of pocket. Call: 833-901-1364 Learn more. BlueCare Dental PPOSM has one of the largest dental PPO networks of general and specialty dentists in both Illinois and nationally, which offers members flexibility in choosing a provider. A joint federal and state program that provides hospital expense and medical expense coverage to the low-income population and certain aged and disabled individuals. These cards assist PBMs in processing and tracking pharmaceutical claims. 0000002644 00000 n 2 0 obj <>/Metadata 7 0 R/Names 8 0 R/OpenAction 6129 0 R/Outlines 6130 0 R/PageLayout/OneColumn/PageMode/UseOutlines/Pages 838 0 R/StructTreeRoot 2595 0 R/Type/Catalog/ViewerPreferences<>>> endobj 3 0 obj <>/Font<>>>/Fields[]>> endobj 7 0 obj <>stream Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Blue Cross and Blue Shield of Texas (BCBSTX) is providing access to the Dental Wellness Center website as a courtesy, as part of its BlueCare Dental Connection program. 0000046006 00000 n One option is Adobe Reader which has a built-in reader. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. 0000001276 00000 n Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. Additionally, members may have to submit claims for reimbursement. The Patient Protection and Affordable Care Act was signed into law on March 23, 2010, and was amended by the Health Care and Education Reconciliation Act on March 30, 2010. Keep in mind they aren't based on actual prices. HVKH+Djj+r%VF9dje;!h]_gLP8a "&SDi^&=.k)VU_? |7 Use our Premium Finder to easily find your premium amount or take a look at the tables below to determine your premiums. ]YAVdYAV/E These budget-friendly insurance options help lessen the financial impact of unexpected health care costs. Periodontal maintenance p ?P\H19y+_Q /iY.Q6?/??h= $Ng3,M;Tz\LJhzs"N@?XGGy*& b They are not balance billed Network providers will not bill for costs that are in excess of the BCBSTX allowable amount for covered services. State and Federal Privacy laws prohibit unauthorized access to Member's private information. 0000075693 00000 n A toll-free number, 1-800-676-BLUE, for healthcare providers to verify Blue Cross Blue Shield membership and coverage information for patients. 0000062841 00000 n HealthEquity has . HUKo@WoR",8iiz5f. The deductible is usually a set amount or percentage determined by the members contract and is set for a given period of time. These documents also show your estimated costs for two sample medical events: having a baby and managing diabetes. xref BlueCare Dental Connection integrates dental care management and health care management with a focus on preventive care and individual involvement. 0000046543 00000 n Plans to Fit Every Small Business Budget. Register Now, Not registered? hb``b``f`c`pjed@ AV(7{`SopLY-}Piii@ 1)ix`)b}$?G^9[+ 0 fsLRG&c{\.p6^gW||g$k%X86X H36 5 endstream endobj 16 0 obj <>>> endobj 17 0 obj >/PageUIDList<0 218>>/PageWidthList<0 612.0>>>>>>/Resources<>/ExtGState<>/Font<>/ProcSet[/PDF/Text]/Properties<>/Shading<>>>/Rotate 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 18 0 obj <>stream One option is Adobe Reader which has a built-in reader. Plus, it can help them manage their out-of-pocket costs. Blue Cross Blue Shield of Minnesota 0000076479 00000 n 1996-document.write(new Date().getFullYear()); Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. Blue Cross Blue Shield FEP Dental An important component of BlueCare Dental Connection is the Dental Wellness CenterTM*, which will be available to members and offers online resources and support tools that allow members to: Note: The information provided by the BlueCare Dental Connection program is not a substitute for professional health care. 1996-2022 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. BlueCare Dental Connection integrates dental care management and health care management with a focus on preventive care and individual involvement. A process in which a healthcare organization undergoes an evaluation of its operating procedures to determine whether the procedures meet designated criteria as defined by the accrediting body, and to ensure that the organization meets a specified level of quality. A computerized record of a patient's clinical, demographic and administrative data. Allows members to use pre-tax dollars for certain eligible medical and dependent care expenses. A type of Health Benefit Plan that allows members to go outside the network for non-emergency care, but may result in a lower level of benefits being paid by the Health Benefit Plan. A value-added discount program that provides Blue Cross and Blue Shield members with discounts and content on health and wellness, family care, financial services and healthy travel . 0000139770 00000 n 0000011502 00000 n 0000006097 00000 n Pursuant to Section 1557 Blue Cross Blue Shield FEP Dental does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, age, disability, or sex (including pregnancy and gender identity). We calculate our dental premiums based on your location (rating areas) and the plan option you select. TTY users dial 711. uuid:12624d0f-e408-42fe-a02c-8c7e042553c9 0000005030 00000 n Use ourProvider Finderto search for doctors and pharmacies near you. Calling BlueCard Eligibility will facilitate efficient payment for the provider. Blue Cross and Blue Shield of Texas (BCBSTX) covers emergency dental services your child gets in a hospital or ambulatory surgical center. Also known as disease state management. 0000072854 00000 n A dental service plan that allows a member to use either a dental health maintenance organizations (DHMO) network dentist or to seek care from a dentist not in the health maintenance organization's (HMO) network. With BlueCare Dental PPO 1A, you'll get: One of the highest maximum annual benefit levels available - up to $1,500 per person per year Orthodontic services covered up to age 19 No annual maximum on BlueCare Dental 4 Kids 1A 0000049503 00000 n Cleanings are covered twice a year. We provide health insurance in Michigan. WalkingWorks is a physical fitness and wellness program developed by Blue Cross Blue Shield, in cooperation with the Presidents Council of Physical Fitness and Sports, to help BCBS members reach fitness goals while improving your overall health. Individual medical expense insurance policies sold by state-licensed private insurance companies. Select "Log In To My Account" from the large center banner For dental care, you can go to any licensed dentist and this plan will share the cost. 0000012040 00000 n Also known as a group practice model HMO. 0000003753 00000 n After a 12-month waiting period, cover is extended to major procedures including dentures, implants, crowns and orthodontics - all subject to an annual maximum of $1,500. Provider Finder from Blue Cross and Blue Shield of Texas (BCBSTX) is a fast, easy-to-use tool that improves member experience when theyre looking for in-network health care providers. If you can't find what you're looking for, please visit our Contact Us page for further assistance. Blue Cross Blue Shield companies provide a best-in-class, comprehensive suite of international products and services for people who live, work and travel internationally, giving them confidence that quality care can be accessed wherever and whenever they need it. Get access to your agent portal. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association NOT FOR DISTRIBUTION TO BENEFICIARIES, MEMBERS, OR PROSPECTS BlueCare Dental Classic Plans 1,2 BlueCare Dental Classic plans cover only one person per policy. Our AskBlue. You pay50%after deductible before meeting your out-of-pocket max, and $0 after meeting your out-of-pocket max. These documents also show your estimated costs for two sample medical events: having a baby and managing diabetes. A plan under which an employer's group health plan, disability plan and workers' compensation program are merged, integrated or coordinated (depending on state regulations) into a single health benefit plan that covers employees 24 hours a day. Nova Scotia. With the Premium plan preventive care is free and after 6 months the co-payment for fillings and simple extractions is just 20%. Blue Cross and Blue Shield of Texas, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). 0000023853 00000 n Which is the best romantic novel by an Indian author? Your child's Medicaid dental plan provides dental services including services that help prevent tooth decay and services that fix dental problems. A summary of benefits and coverage explains things like what a health insurance plan covers, what it doesn't cover, and what your share of costs will be. An extension of the Blue Cross Blue Shield WalkingWorks program, this event helps people incorporate physical activity into their workday and encourages them to increase their daily physical activity by walking at lunch. . A review program that evaluates whether drugs are being used safely, effectively and appropriately. Also known as preventive care programs or wellness programs. 0000107951 00000 n Covered once per arch every 84 months. 44 0 obj <> endobj 0000017747 00000 n Please call 1-888-288-2738 and we'll help. We will work with and follow all COVID-19 guidance and protocols provided by the Centers for Disease Control Outside the United States. President of Blue Cross and Blue Shield of Texas The Dental Schedule of Coverage enclosed with this Benefit Booklet indicates benefit percentages, Deductibles, maximums, and other benefit and payment issues that apply to the Plan. See the chart on the back for more plan details. 0000041318 00000 n 0000049163 00000 n 0000076327 00000 n The process of obtaining all the information necessary to determine the appropriate amount to pay on a given claim. Fluoride treatments Site Map|Feedback|Download Adobe Acrobat Reader, Learn more about a Healthier Michigan.org, Glossary of Health Coverage and Medical Terms, Important Information About Medicare Plans. 0000050197 00000 n 0000000016 00000 n ;m* (Coverage is not available for non-network dentists in Massachusetts except for covered emergency services.) The network comprising those physicians, hospitals and other healthcare providers PPO members may elect to use to obtain the highest level of PPO benefits. 2016-09-06T07:14:49-05:00 211 Canada. Some examples are: (1) a provider who physically examines the patient, (2) a lab that performs the blood draw from a patient, or (3) a technician who fits a prosthetic limb to the patient. A specified dollar amount that a member must pay out-of-pocket for a specified service at the time the service is rendered. BlueCard Access assists members who need a referral to a physician or healthcare facility in another location. 0000002464 00000 n 0000072686 00000 n Major services like crowns and bridges. Programs designed to educate and motivate members to prevent illness and injury and to promote good health through lifestyle choices, such as smoking cessation and dietary changes. A cost containment program that recovers money for healthcare where primary responsibility does not exist because of another group health plan or contractual exclusions.
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