Your Plan Is Up for Renewal Stay BLUE · 2014-11-04 · Renew Your Plan Today! This is your renewal...
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Your Plan Is Up for Renewal Stay BLUE ®
Transcript of Your Plan Is Up for Renewal Stay BLUE · 2014-11-04 · Renew Your Plan Today! This is your renewal...
Your Plan Is Up for RenewalStay BLUE ®
Why Stay BLUE?BlueCross BlueShield of South Carolina is a company you trust. Ensuring access to quality health coverage is vital to the health and well-being of every community in our state. Having served South Carolina for almost 70 years, we’re more than a recognized member of the community — we’re a strong and stable partner you know you can count on.
As a member you can continue to:
Experience our widely recognized provider network.
Take advantage of free preventive services like annual wellness visits and immunizations.
Experience the special value-added benefits we offer.
Get your questions answered by an award-winning customer service team.
Be part of a long-standing, trusted brand.
We’re South Carolinians serving South Carolinians … and we’ll continue to be here for you.
Preventive and Wellness ServicesYour plan covers preventive services for children, women and men. These
include screenings like blood pressure
and cholesterol screenings, breast cancer
screenings and immunizations. Being proactive
about your family’s health can prevent future
illness and improve overall wellness.
Annual visits to the doctors, including
well-woman visits and physicals, are also
covered. Don’t skip these appointments! It’s
important to get checked out by a doctor once
a year to keep you and your family healthy.
Important Dates to Rememberl Renewal materials mailed and available
for your review on My Health Toolkit®November 1, 2014
l Renew your plan with no changes Pay January 2015 premium no later than December 31, 2014
l Change your plan or plan options for 2015Make changes at www.SouthCarolinaBlues.com by
December 15, 2014.
*Pay January 2015 premium no later than December 31, 2014
l 2014 Plan Year ends December 31, 2014
l New Plan Year begins January 1, 2015
l New Plan Year ends December 31, 2015
Renew Your Plan Today!This is your renewal package. We will renew your policy for you, unless you wish to make a change and inform us prior to December 15, 2014.
However, contact us if you are receiving financial assistance or had a change in family status such as:
l Marriage
l Birth
l Change of address
l Increase/ decrease in income
l Change in employment
You can call us, contact your agent or visit one of our retail centers to look at our new family plans. We can
also tell you if you are receiving the correct amount of financial assistance.
Call 855-404-6752 and a customer service advocate can assist you.
Contact your agent.
Visit a South Carolina BLUESM retail center near you.
IMPROVE YOUR WELLNESS
• Personal Health Record — A confidential, online tool providing a summary of all your health information, including doctors’ visits, prescriptions, lab results and much more. You also can keep track of upcoming medical appointments and print a copy of your medical history. Additional features are available, based on your benefit plan.
• Personal Health Assessment — An online survey that helps identify risk factors and offers ways to improve your health based on your answers.
• Health Library — This feature offers medical information, health calculators, self-care channels and nutrition guides to help improve and protect your health status.
MAKE INFORMED HEALTH CARE DECISIONS
• Compare Drug Costs — Look up cost and consumer information regarding prescription drugs covered under your plan.
• Find a Doctor — Find a network doctor or hospital across the country and around the world.
• Find a Pharmacy — Find a network pharmacy near you.
What can you do on My Health Toolkit?
MANAGE YOUR BENEFITS
• Claims Summary — View claims status and an Explanation of Benefits (EOB).
• Eligibility and Benefits — Read about your benefits and coverage information and check your eligibility.
• Deductible and Out-of-Pocket Statuses — See how close you are to meeting your deductible and out-of-pocket maximum.
• Request a New ID Card
• Pay Your Premium Bill — You can conveniently log in and pay your bill at any time!
• Ask Customer Service — Send a secure message directly to the customer service area that handles your coverage for faster answers to your questions.
My Health Toolkit®
SETTING UP AN ACCOUNT IS EASY!
1 Go to www.SouthCarolinaBlues.com.
2 On the home page, find the “Member Login: My Health Toolkit” box and click “Register Now!”
3 Create your profile by entering your member information found on your insurance card. Follow the remaining steps to complete your profile.
YOUR ONE-STOP SHOP FOR ALL YOUR MEMBERSHIP NEEDS.
FITNESS AND WELLNESS
Fitness Center Memberships Getting in shape is now more affordable than ever! We make it easy for our members to save on memberships to local fitness facilities and other exercise centers.
Weight Management Enjoy discounts on weight loss programs and services, including Jenny Craig. Plus, get one-on-one support to help you lead a healthy lifestyle.
Alternative Health Care Where does it hurt? With NaturalBlue,SM you can tap into an extensive network of credentialed acupuncturists, massage therapists, chiropractors, plus diet advisers — all offering extensive discounts.
Allergy Relief You’ll breathe easier thanks to special prices on products designed to reduce exposure to indoor allergies.
Children’s Fitness With My Gym Children’s Fitness Center, choose from a variety of structured, age-appropriate classes that use music, dance, relays, games and more.
HEARING AND VISION
Laser Vision Correction You’ll see exclusive discounts on Lasik surgery offered through QualSight, a national network of credentialed Lasik surgeons.
Eye Care Open your eyes to special savings from Vision One — eye exams, designer frames, lenses and contacts.
Hearing Care Hear that? With Blue, get great savings from TruHearing — a leader in digital hearing aids and ranked No.1 in customer service. Save on hearing exams and follow-up care, too.
COSMETIC
Cosmetic Surgery Lift your spirits with preferred rates on face-lifts, breast lifts, breast augmentation and reduction, tummy tucks, nose reshaping, ear pinning, even cheek and chin augmentation. Save on nonsurgical procedures, too.
Hair Restoration Suffering from hair loss? You have everything to gain. As a member, you’ll save 20 percent on a hair transplantation procedure.
BLUE365®
Wellness Discounts As a BlueCross member, you have access to Blue365, a daily deal website with discounts on various wellness products and services. Blue365 complements your health coverage by making it easier and more affordable to make healthy choices. Visit Blue365deals.com/BCBSSC for the deal of the day!
DISCOUNT AND VALUE-ADDED PROGRAMS
Sometimes all you need to feel great is a little sprucing up. That’s why our members enjoy discounts and value-added programs such as:
PRESCRIPTION DRUG COVERAGE
BlueEssentialsSM Covered Drug List The BlueEssentials Covered Drug List is the list of drugs we cover under your plan. BlueCross BlueShield of South Carolina works with a team of health care providers to choose drugs that provide quality treatment. Find the BlueEssentials Covered Drug List on our website, www.SouthCarolinaBlues.com. Or for specific drug costs of your current plan and coverage rules, log in to My Health Toolkit.
Saving you money while offering you choices We have many different ways to save you money and give you choices. When looking at the BlueEssentials Covered Drug List, be sure that you carefully review the tier of the drug.
Take your prescription to one of our thousands of Retail Network pharmacies. Find a list of network pharmacies by going to www.SouthCarolinaBlues.com and logging in to My Health Toolkit. Where applicable, you could get a 90-day supply of covered maintenance medications from our mail-order pharmacy. Call the customer service number on the back of your ID card to get mail order started. If your drug is designated as a specialty drug on the Covered Drug List, it’s available from our Specialty Pharmacy. You also can start this process by calling the Customer Service number on the back of your ID card.
What if my drug is not on the BlueEssentials Covered Drug List?
In general, there are no benefits for drugs not covered on the BlueEssentials Covered Drug List. If your drug is not on this list, call Member Services to verify that your drug is not covered.
If you learn that BlueCross does not cover your drug, you have two choices:
1 Use the BlueEssentials Covered Drug List to work with your health care professional to find another medication that is covered.
2 Ask BlueCross to make an exception and cover your drug.
Generally, BlueCross will only approve your request for an exception if the medications on the BlueEssentials drug list are not as effective as the non-covered drug in treating your condition or if they cause adverse side effects.
Tier 1
Drugs on this tier are usually generic and will generally cost you the least amount of money out of your pocket.
Tier 2
Drugs on this tier are most often brand drugs, sometimes referred to as “preferred” drugs, because they usually cost you less than other brand drugs.
Tier 3
Drugs on this tier are most often brand drugs, sometimes referred to as “non-preferred” drugs, because they usually cost you more than other brand drugs. They may have generic equivalents.
Tier 4
These are usually expensive drugs that treat complex conditions. You will usually pay more for drugs in this tier.
FREQUENTLY ASKED QUESTIONS
Q: How can I pay my bill?
A: • Pay online through My Health Toolkit at SouthCarolinaBlues.com.
• Visit a South Carolina BLUESM retail center near you (see back cover for locations)
• Call 855-404-6752 to pay by phone
Q: Do I have a grace period to make my payment?
A: Your payment is due on the first of every month. If your payment is not received by the first, you will not be able to receive benefits.
Q: Who is covered on my policy?
A: For specific member coverage information, refer to your BlueEssentialsSM Member and Premium Schedule.
Q: How can I add my child or spouse?
A: You can add your child or spouse to your policy during open enrollment. Or if one of you has a qualifying life event you can enroll in your same or new coverage as a special enrollment period (SEP).
Q: How do I change my address?
A: • You can contact us at 855-404-6752 or contact your agent.
• You can log in to your account by visiting www.HealthCare.gov.
Q: When will I get my ID card?
A: You will receive your ID card seven to 10 business days before your coverage begins.
Q: I have a friend who has her prescriptions mailed to her. Is that an option for me?
A: Yes. To find out more, call Caremark at 888-277-4144. Caremark is an independent company that manages prescription drug benefits on behalf of BlueCross.
Q: Why did my pharmacy say that a drug requires prior authorization?
A: There are different reasons a drug might require prior authorization. Some of the reasons include ensuring the appropriate quantities are being used, that the drug is being used in accordance with FDA approved indications and that the most cost-effective therapy for you is being used. The pharmacy or your doctor will need to contact Caremark at 800-337-5022.
Q: What does it mean that my drug has a quantity limit?
A: Based on the FDA guidelines, we will only cover a certain amount of the drug you are taking for a specific period of time.
Q: What happens if I am under the care of a physician who is not in your BlueEssentials Network?
A: Please call us at 855-404-6752 to request a Transition of Care Authorization form. Once you complete the form and return it to us, we can evaluate if your situation qualifies for transition of care benefits.
Visit a South Carolina BLUE retail center for:
n Face-to-face service n Free classes and seminars
n Bill payment n Expert advice
Look for one of the SC BLUESM RVs at a community event near you.
MOBILE UNIT 855-382-BLUE (2583) | [email protected]
Have Questions? Call us 855-404-6752 | [email protected]
Message us through My Health Toolkit.
Mail us: P.O. BOX 100228, AX-F21, Columbia, SC 29202-3228
Call us if you:• Need this information interpreted in another language.
• Would like this information in an alternate format, including large print and audiotapes.
COLUMBIA 1260 Bower Parkway Columbia, SC 855-592-BLUE (2583)[email protected]
GREENVILLE 1025 Woodruff Road Greenville, SC 855-392-BLUE (2583)[email protected]
MOUNT PLEASANT 1795 Highway 17 North Mount Pleasant, SC 855-492-BLUE (2583)[email protected]
www.SCBlueRetailCenters.com
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