MP 7.01.47 - Bariatric Surgery - Effective 02/19/2020 ... About Blue Cross of Idaho / Pre-pregnancy. INDIVIDUAL & FAMILY. Blue Cross of Idaho's Short Term PPO sm offers a limited benefit program for temporary coverage. Policy Notice of Medicare Non-coverage (NOMNC) Reporting. The Blue Cross of Idaho formularies list drugs approved for coverage under your policy. 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. Box 8406, Boise, ID 83707 Please enter a valid Zip Code. POWERED BY BLUE CROSS OF IDAHO CARE PLUS, INC 3 . 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. Please fill in all of … Set up your Blue Cross of Idaho member portal login at members.bcidaho.com.. Contact your insurange agent or Blue Cross of Idaho account representative to find an affordable health coverage option for your business. 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 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. MERIDIAN — Blue Cross of Idaho has waived all member cost-sharing for testing and treatment of COVID-19, the company announced Thursday. The Preventive Drug List (2020 and 2021) provides a list of medications covered under the preventive drug benefit . Details Drug Coverage for the Blue Cross of Idaho True Blue Rx Gem H1350-024 (HMO) in Idaho. Sign on and check your benefits today! Plan brochure. You can also contact us to ask for a coverage decision before you receive certain medical services. 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 provides health insurance, dental insurance, and medicare advantage coverage to the residents of Idaho. 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. 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. 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. No Remove. 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. {{theModel.firstDateLabel}} {{theModel.secondDateLabel}} Date of Event * Zip Code. To locate a participating pharmacy, visit our Pharmacy Locator. payment to your local Blue Cross of Idaho district office (listed on the back of this brochure). In excess of the maximum allowance. True Dental Complete: Full preventive and comprehensive dental coverage. 4 SUMMARY OF BENEFITS . • Blue Cross of Idaho will send you a member ID card with your policy after we approve your application. Select Benefits and Coverage from the Prescription Drugs menu. Write Blue Cross of Idaho Care Plus, P.O. 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. Medical Policy Library Table of Contents : Section Mental Health: Original Policy Date October 2015 : Disclaimer. This option does not allow you to take advantage of either your subsidy or possible catastrophic benefit. If you use the providers in our network, you may pay less for your covered services. Details Drug Coverage for the Blue Cross of Idaho True Blue Rx Option II H1350-016 (HMO) in Idaho. 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. 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. 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 … 2. Blue Cross of Idaho administers COBRA coverage for state of Idaho group members. Box 8406, Boise, ID 83707 Find a provider in your area! 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. You’ll need your Blue Cross of Idaho member ID card to get started.). 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). 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. Please have your Blue Cross of Idaho member ID available. Get more information on Healthy Smiles plans. We offer affordable choices that: 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 Some, but not all ACA drugs are listed in the formularies. Preventive Services. Facility Phone City Plan / Network; Bingham Memorial Hospital 98 Poplar Radiology Department Blackfoot, ID 83221 (208) 785-3807: * Please Select Your County: * First Name * Last Name * Date of Birth * Tobacco User? For fast (expedited) coverage decisions, call the same number at 1-888-494-2583 (TTY 711). 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. You must be logged-in to view this page. Receipt of benefits is subject to satisfaction of all terms and conditions of the coverage. SUMMARY OF BENEFITS POWERED BY BLUE CROSS OF IDAHO CARE PLUS, INC Which doctors and hospitals can I use? Blue Cross of Idaho offers coverage for mammogram screenings. 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. 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). It’s that simple. Quantity Limits for Commercial and Qualified Health Plans are included in the formulary. Plans for Everyone. You can learn more about cost-sharing, coverage limitations, and if you need a referral to see a specialist. Find plans that bring peace of mind to you and your family. *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. Details Drug Coverage for the Blue Cross of Idaho True Blue Rx Preferred H1350-021 (HMO) in Idaho. True Blue Rx Essentials members have a $3,000 coverage limit. 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. There is an individual deductible of $50 per member per benefit period. Follow the additional prompts to complete a Cost & Coverage check. You can learn more about cost-sharing, coverage limitations, and if you need a referral to see a specialist. Healthy Smiles also uses Blue Cross of Idaho’s preferred provider organization (PPO) network of over 900 dentists and other dental providers in Idaho, … A deductible is the amount of expenses that must be paid out of pocket before the Initial Coverage period begins. The use of generic medications is a valuable way to reduce overall prescription drug costs without sacrificing quality. But if you want to, you can also use … MP 3.01.508 - Neuropsychological Testing - Effective 08/25/2020; Pending Policy. Drugs are categorized into benefit levels, also known as tiers, which determine the amount you pay. To help fill the gaps in your Medicare coverage, Blue Cross of Idaho Care Plus offers Idaho MedPlus Medicare Supplement plans. This is a 4.5-star Medicare Advantage plan. Sales Guide; Outline of Coverage (includes monthly premium rates) Application; 2021 Monthly Premium Rates 2020 Evidence of Coverage for Blue Cross Idaho Medicaid Plus 5 Chapter 1. Sort by Facility or City. Prior authorization is the process of determining medical necessity for a nonemergency medical service or procedure. The expansion covers cost-share treatment received through June 30, 2020 and is offered at no additional premium cost. The Blue Cross of Idaho formularies list drugs approved for coverage under your policy. Refer to the Blue Cross of Idaho Care Plus, Inc. Summary of Benefits for more information. You can find a list of services that require prior authorization by calling customer service, reading your contract or by clicking here. 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) 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. You must be logged-in to view this page. Although generic drugs are chemically the same as their branded counterparts, they are typically sold at substantial discounts from the branded price. 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. However, the insured could be financially responsible for services found to be not medically necessary when provided by a noncontracting provider. Protect yourself from the coverage gaps in Original Medicare and live healthier with our Medicare Advantage plans. Find a provider in your area! To continue coverage, the insured person must elect coverage within sixty (60) days after group coverage terminates. Plans for Everyone. At Blue Cross of Idaho, we understand Idahoans must have options for affordable healthcare coverage, with the financial peace of mind they deserve. At Blue Cross of Idaho, we understand Idahoans must have options for affordable healthcare coverage, with the financial peace of mind they deserve. 8211. Access Plan Formulary - 6 Tier for Access Plans - for individual plans that are available directly through Blue Cross of idaho. This is a 3.5-star Medicare Advantage plan. Qualified Health Plan Formulary - 6 Tier for Metal Level Plans - for individual and small group Affordable Care Act plans that are available through the healthcare exchange at Your Health Idaho or directly through Blue Cross of Idaho. This is a 3.5-star Medicare Advantage plan. 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. If you're looking to make a change, you may save money by staying blue. Active Policy. N/A; Retired Policy Versions. Generic drugs are equivalent to brand-name drugs in dosage, safety, strength, route of administration, quality, performance characteristics and intended use. (If you don’t have one, creating one is easy. We write our medical guidelines to cover a given condition for the majority of people, and review and update our policies to keep them consistent with changing medical science. In an example provided by Blue Cross of Idaho, a family of four would pay a monthly premium of $933 for the insurer's ACA-compliant Bronze 5500 plan with a deductible of $11,000. If you would like to know more about Specialty medications, please visit the Specialty Drugs page. 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 . 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