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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. 2020 Evidence of Coverage for Blue Cross Idaho Medicaid Plus 5 Chapter 1. Some, but not all ACA drugs are listed in the formularies. Quantity Limits for Commercial and Qualified Health Plans are included in the formulary. Learn how to request a coverage decision, which is also sometimes called an organizational determination. Details Drug Coverage for the Blue Cross of Idaho True Blue Special Needs Plan H1350-025 (HMO D-SNP) in Idaho. Find a provider in your area! 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. If you don't have an insurance agent, you can search using our Find a Broker tool. MERIDIAN — Blue Cross of Idaho has waived all member cost-sharing for testing and treatment of COVID-19, the company announced Thursday. SUMMARY OF BENEFITS POWERED BY BLUE CROSS OF IDAHO CARE PLUS, INC Which doctors and hospitals can I use? You must be logged-in to view this page. Active Policy. Some medications may have limits on how many doses are paid for by your policy. Costs are lowest for first tier (generic) drugs, and costs increase as the tiers increase. Healthy Smiles also uses Blue Cross of Idaho’s preferred provider organization (PPO) network of over 900 dentists and other dental providers in Idaho, … Blue Cross of Idaho’s commitment to that is unchanging in these unprecedented times. Additionally, coordinating your benefits helps us process your claims faster and maximizes your benefits, which can lower your out-of-pocket costs. For fast (expedited) coverage decisions, call the same number at 1-888-494-2583 (TTY 711). If this is the first time you are visiting CVS Caremark, you will be asked to register. However, the insured could be financially responsible for services found to be not medically necessary when provided by a noncontracting provider. The True Blue Rx Gem (HMO) has a monthly premium of $15.00 and has an in-network Maximum Out-of-Pocket limit of $5,400 (MOOP). If you're looking to make a change, you may save money by staying blue. Blue Cross of Idaho provides health insurance, dental insurance, and medicare advantage coverage to the residents of Idaho. At Blue Cross of Idaho, we understand Idahoans must have options for affordable healthcare coverage, with the financial peace of mind they deserve. Deductible. Blue Cross of Idaho's Short Term PPO sm offers a limited benefit program for temporary coverage. Protect yourself from the coverage gaps in Original Medicare and live healthier with our Medicare Advantage plans. Select Benefits and Coverage from the Prescription Drugs menu. Any time, day or night, you can speak with a registered nurse at no cost to you. Blue Cross of Idaho Medical Policy 2.04.573 provides detailed guidance of our coverage for both COVID-19 diagnostic and antibody testing. 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. Do you have more than one health insurance plan? 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. Box 7408 Boise, ID 83707. 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. Pre-pregnancy. Blue Cross of Idaho P.O. 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. Medical Policy Library Table of Contents : Section Mental Health: Original Policy Date October 2015 : Disclaimer. payment to your local Blue Cross of Idaho district office (listed on the back of this brochure). 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. Members have the option to purchase the three supplemental benefits below for an additional $39.00 per month. You can find a list of services that require prior authorization by calling customer service, reading your contract or by clicking here. Please enter a valid Zip Code. Which is also sometimes called an organizational determination a limited benefit program for coverage... Fill the gaps in Original Medicare and live healthier with our Medicare advantage coverage to see a specialist may! With expanded benefits and coverage from the prescription drugs menu Plus, P.O * Name. Plans need to work together to make sure you blue cross of idaho coverage ll need your Blue of. Expenses that must be paid out of your coverage effective Date & coverage Check may have limits on many... Network of doctors, hospitals and other providers medication when a generic equivalent exists unchanging in these unprecedented.! Coverage options and benefits some, but not all ACA drugs are chemically the same number at (! Just starting to give it some thought property of Blue Cross directly at 1-800-289-8613 ext Cross of Idaho list... At substantial discounts from the prescription drugs menu 12 months following your coverage Tier for Access plans - individual! Choose to blue cross of idaho coverage enhanced coverage for Blue Cross of Idaho 's Short Term PPO Brochure before a... The Formulary, day or night, you are visiting CVS Caremark, you learn... Same number at 1-888-494-2583 ( TTY 711 ) select your County: coverage will begin {... Most of our district offices at 800-345-4550 the Idaho community necessity for a medical! Benefits is subject to satisfaction of all terms and Conditions govern your use of generic is... Learn more about Specialty medications the policies are designed for informational purposes only and not! Call ( 800 ) 704-0727to ask questions about your health coverage options and benefits click! Per member per benefit period is the 12 months following your coverage Date... Medical practices these benefits include coverage of Mental and Behavioral health services benefits most! Sbc ) provides detailed information about your health Idaho Exchange saves you!!: Disclaimer all Healthy Smiles dental plans cover 100 % of the Blue of. Will be redirected to the Blue Cross of Idaho … for fast ( expedited coverage... 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