1 / 10

Town of Duxbury Benefit Changes to Active Plans Network Blue NE /Blue Care Elect Preferred 7-1-14

Town of Duxbury Benefit Changes to Active Plans Network Blue NE /Blue Care Elect Preferred 7-1-14. Agenda. Highlight the changes effective 7-1-14 Network Blue NE and Blue Care Elect – In Network ONLY Discuss deductible scenarios Review hospital tiering RX co-payment change Questions???.

lark
Télécharger la présentation

Town of Duxbury Benefit Changes to Active Plans Network Blue NE /Blue Care Elect Preferred 7-1-14

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Town of Duxbury Benefit Changes to Active Plans Network Blue NE /Blue Care Elect Preferred 7-1-14

  2. Agenda • Highlight the changes effective 7-1-14 • Network Blue NE and Blue Care Elect – In Network ONLY • Discuss deductible scenarios • Review hospital tiering • RX co-payment change • Questions???

  3. Deductible 7-1-14 $250 Individual/$500 Two Party and $750 Family deductible Impacts services on or after 7-1-14. Deductible is plan year You do not pay deductible up front. Each claim that has a deductible applied will process by BCBSMA and you and provider will get notice Claims Summary – retain as all information regarding deductible and Out of Pocket expenses

  4. More on Deductible… • Deductible does NOT apply to Office Visits or Prescription Drugs • Deductible does apply to : • Emergency Room Services • High Tech Radiology Services • Inpatient Admissions • Surgical Day admissions • X –Rays and Labs

  5. Deductible and Co-payments • These are your costs after deductible : Emergency Room $100 Inpatient Admission $300 or $700 Surgical Day $150 High Tech Radiology $100

  6. Hospital Co-payments are structured by Cost/Quality • High cost/high quality hospitals $700 co-payment • South Shore, MA General, Brigham and Women’s, Children’s Lower cost/high quality $300 co-payment • Jordan, Beth Israel, Tufts New England Medical Center

  7. Co-payment only : • All office visits except Preventive • $20 for PCP /PCP Type $35 for Specialists • All prescription drugs-except generic birth control. • $10/25/50 for 30 days retail and $20/50/110 for 90 days mail ( no deductible) List of $9 RX for 90 days generic

  8. Added protection • Maximum Out of Pocket ( MOOP) Plan Year • Network Blue NE and Blue Care Elect ( in network) • $5000 Individual/$10000 Fam. All member cost share EXCEPT RX counts toward MOOP. • 7-1-15 the RX co-payments will be included

  9. Extra’s • $300 Fitness Benefit • $150 Weight Loss Reimbursement • $90/45 Child Education Classes • $9 Generic Mail Order List • Discounts on eye glasses, alternative therapies :massage, acupuncture etc

  10. Questions?

More Related