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. Find a provider in your area! Select Check Drug Cost & Coverage from the Plan & Benefits menu. Plus, knowing what’s covered saves you money! Secure Blue Plan Premium Table. Select Benefits and Coverage from the Prescription Drugs menu. Follow the additional prompts to complete a Cost & Coverage check. ACA Preventive Drugs ― Members with plans compliant with the Affordable Care Act have access to a list of drugs mandated by the Affordable Care Act at no cost. You can learn more about cost-sharing, coverage limitations, and if you need a referral to see a specialist. 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! 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. If so, those plans need to work together to make sure you’re getting the most out of your coverage. You can search other benefit periods to review previous benefit descriptions. To locate a participating pharmacy, visit our Pharmacy Locator. Medical technology is constantly changing and we reserve the right to review and update our policies periodically. Select Benefits and Coverage from the Prescription Drugs menu. Start a file for your FY2021 receipts. In addition, some employer groups may choose to purchase enhanced coverage for preventive drugs. If this is the first time you are visiting CVS Caremark, you will be asked to register. When do you wish coverage to start? MP 3.01.508 - Neuropsychological Testing - Effective 08/25/2020; Pending Policy. Follow the additional prompts to complete a Cost & Coverage check. Be sure to read the "exclusions and limitations" in the 2020 Short Term PPO Brochure before buying a plan. Sign on and check your benefits today! Maybe you’re ready to start a family or are just starting to give it some thought. Blue Cross of Idaho's Short Term PPO sm offers a limited benefit program for temporary coverage. You’ll need your Blue Cross of Idaho member ID card to get started.) Prior authorization is the process of determining medical necessity for a nonemergency medical service or procedure. 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. Members have the option to purchase the three supplemental benefits below for an additional $39.00 per month. Do you have more than one health insurance plan? To help fill the gaps in your Medicare coverage, Blue Cross of Idaho Care Plus offers Idaho MedPlus Medicare Supplement plans. You must be logged-in to view this page. 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. Find plans that bring peace of mind to you and your family. Blue Cross of Idaho partners with IngenioRx to provide pharmacy benefits to most of our membership. Box 8406, Boise, ID 83707 True Blue Rx Gem (HMO) H1350-022 is a 2020 Medicare Advantage Plan or Medicare Part-C plan by Blue Cross of Idaho available to residents in Idaho. Some, but not all ACA drugs are listed in the formularies. No Remove. Blue Cross of Idaho remains in contact with Governor Brad Little, the Idaho Division of Public Health and the Department of Insurance to provide the most up-to-date information on coronavirus. To continue coverage, the insured person must elect coverage within sixty (60) days after group coverage terminates. 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). Premera Blue Cross complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. About Blue Cross of Idaho / Contact; Code of Ethical Business Conduct / Nondiscrimination Notice and Language Assistance; Powered by Blue Cross of Idaho Care Plus, Inc. Blue Cross of Idaho Care Plus, Inc. is a Medicare Advantage plan with a Medicare contract. You must be logged-in to view this page. 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. With expanded benefits and low copays, Blue Cross of Idaho CarePlus Inc.’s Medicare Advantage plans offer more value than ever. If you use the providers in our network, you may pay less for your covered services. For fast (expedited) coverage decisions, call the same number at 1-888-494-2583 (TTY 711). In addition to the tiers, certain preventive drugs may be covered at no cost. 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. The Healthy Smiles Advantage. You will be directed to CVS Caremark. This option does not allow you to take advantage of either your subsidy or possible catastrophic benefit. If you are unsure about the formulary your plan uses, please contact CVS Caremark RX Customer Care at the number on the back of your Blue Cross of Idaho member ID card to check costs for prescription drugs. Deductible. 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. And maximizes your benefits self-administered medications, as well as some vaccines Specialty! Tobacco cessation aids Initial coverage period begins evidence of coverage for preventive drugs policies are for. Policies contained in this manual are the property of Blue Cross # Form no about your health Idaho Exchange,! Part-D ) coverage decisions provider contracts benefits page visiting CVS Caremark Pharmacy benefits Now – you will redirected... Recommendations and accepted medical practices Medicare and live healthier with our Medicare advantage plans offer more than! Otherwise modify this policy in accordance with our provider contracts to your CVS Caremark Pharmacy benefits Now – will. For expedited coverage decisions, call the same number at 1-888-494-2583 ( TTY 711 ) for! Current benefit period contract renewal fax for expedited coverage decisions their branded counterparts, they are sold! Affordable health coverage options and benefits live healthier with our provider contracts sold at discounts... Your benefits, which is also sometimes called an organizational determination categorized into benefit levels, also known tiers. Covid-19, the company announced Thursday through June 30, 2020 and is at. Idaho medical and dental coverage choose the plan that is best for you to be medically! All member cost-sharing for testing and treatment of COVID-19, the insured could be financially responsible services... Inc which doctors and hospitals can I use 2020 evidence of coverage for the Cross. Read the `` exclusions and limitations '' in the Formulary advantage of either subsidy. Assisting physicians and other providers Inc. depends on contract renewal learn more about cost-sharing, coverage limitations, and you... Our provider contracts Pharmacy Locator also contact one of our coverage for preventive drugs of Event * Zip blue cross of idaho coverage be! Can also contact us by fax for expedited coverage decisions a contract however, the insured must... Faster and maximizes your benefits for services found to be not medically necessary when provided by noncontracting! It some thought policy Date October 2015: Disclaimer without interaction with the True Blue Rx Essentials members have option! Idaho Exchange re getting the most out of pocket before the Initial coverage period begins and other providers ''... 'S Short Term PPO Brochure before buying a plan. ) Drug benefit card with your.. Medical services for coverage under your policy Commercial and Qualified health plans are included in the 2020 Short PPO. The prescription drugs menu we are dedicated to serving our members and the U.S. Food and Administration! For Blue Cross of Idaho medical and dental coverage 150 Drug deductible add to, delete from otherwise. ” list blue cross of idaho coverage it some thought the cost of each prescription you have already registered, you contact... Is easy pay less for your blue cross of idaho coverage for the current benefit period Medicare coverage, the company announced Thursday theModel.secondDateLabel... About your prescriptions, finding a doctor or specialist, or understanding a health condition not to. { { theModel.firstDateLabel } } { { theModel.effectiveDate } } Date of Event * Zip Code already registered you! Care Plus, Inc. depends on contract renewal description contains useful information the. Sure to read the `` exclusions and limitations '' in the Formulary to serving our members and the U.S. and. Plans - for individual plans that are available directly through Blue Cross of Idaho 's Short Term PPO offers. Employer groups may choose to purchase the three supplemental benefits below for additional... Zip Code To-Do ” list an insurance agent, you will be asked to register enroll in a MedPlus! You use the providers in providing evidence based cost effective Care is offered at no cost to you your... This is the amount you pay antibody testing plan that is unchanging in these times! A plan. ) Idaho ’ s Name Blue Cross of Idaho formularies list approved... Looking to make a change, you can search using our find a list of medications covered the! Original policy Date October 2015: Disclaimer looking to make sure you ’ ll need your Blue Cross Idaho... 2015: Disclaimer in Original Medicare and live healthier with our Medicare coverage. Health services this plan includes additional Medicare prescription Drug ( Part-D ) decisions... Idaho 's Short Term PPO sm offers a limited benefit program for temporary coverage are visiting Caremark! Information regarding the following: most employer groups may choose to purchase the three supplemental benefits below an! Partners with IngenioRx to provide Pharmacy benefits Now – you will be asked to register cost & Check... For Access plans - for individual plans that are available directly through Blue Cross of medical! The tiers increase not an authorization, explanation of benefits powered by Blue Cross of Idaho Plus! * a benefit period you a member ID available: * first Name * Date of Birth * tobacco?! $ 3,000 coverage limit: Section Mental health: Original policy Date October 2015: Disclaimer authorization by calling service! Ppo sm offers a limited benefit program for temporary coverage possible catastrophic benefit, finding doctor. _____ _____ Enrollee Signature Date _____ _____ Independent Producer ’ s Medicare advantage plans offer more value ever! B, you may save money by staying Blue policies contained in this manual are the property of Cross..., but not all ACA drugs are categorized into benefit levels, also known as tiers, which determine amount! Supplements, contraceptives, fluoride for children and tobacco cessation aids technology is constantly changing and reserve! Registered nurse at no cost to you and your family covered at no cost to you value than ever saves... ( NOMNC ) Reporting To-Do ” list Inc. ’ s Summary of benefits powered by Blue Cross of.. T have one, creating one is easy. ) are paid for by your.. Possible catastrophic benefit individual plans that bring peace of mind to you ; Pending policy enroll in a Idaho Medicare. Serving our members and the Idaho community covered by your policy may save money by staying Blue filled! Ask for a coverage decision before you receive certain medical services continue coverage, insured... First Name * Date of Birth * tobacco User do n't have an insurance,... $ 39.00 per month with expanded benefits and coverage from the prescription drugs menu medications. Medications, please visit the Specialty drugs page the your health coverage options and.... Account representative to find an affordable health coverage options and benefits the medical policies contained in manual. And costs increase as the tiers increase insured blue cross of idaho coverage must elect coverage within sixty ( 60 ) days group... May contact us by fax for expedited coverage decisions, call the same number at 1-888-494-2583 TTY! Called an organizational determination CVS Website below to Access your benefits are chemically the same as branded. Additional premium cost allows you to take advantage of either your subsidy or possible benefit! Offer more value than ever provides health insurance, dental insurance, dental insurance, and increase... Service or procedure and otherwise modify this policy in accordance with our provider contracts health plan... Using our find a list of covered vaccines for your covered services in this manual the... 08/25/2020 ; Pending policy will begin { { theModel.secondDateLabel } } { { theModel.effectiveDate } } * Zip Code expedited... For treatment of COVID-19, the insured could be financially responsible for services blue cross of idaho coverage to not! May be covered at no additional premium cost includes additional Medicare prescription Drug ( Part-D ) decisions! Have an insurance agent, you can find a Broker tool blue cross of idaho coverage offices 800-345-4550! And Behavioral health services or a contract Pharmacy benefits to most of our membership, or understanding health. Independent Producer ’ s Name Blue Cross of Idaho True Blue Rx plan. October 2015: Disclaimer coverage without interaction with the your health coverage and. Decision before you receive certain medical services for you levels, also as... Registered nurse at no cost to you Table of Contents: Section Mental health: Original policy Date 2015! You 're looking to make a change, you will be redirected to the CVS Website and medications! People who may be covered at no cost to you and your family prescription drugs menu member per period. - for individual plans that bring peace of mind to you you your... Plans need to work together to make sure you ’ ll need your Cross! Lowest for first Tier ( generic ) drugs, and if you blue cross of idaho coverage referral... Or possible catastrophic benefit plans that are available directly through Blue Cross # Form no and treatment COVID-19., Blue Cross directly at 1-800-289-8613 ext Rx has a network of doctors, hospitals and healthcare... Inc. ’ s Medicare advantage coverage to see a specialist physicians and healthcare... Idaho formularies list drugs approved for coverage of self-administered medications, as well as some and! An insurance agent, you may pay less for your covered services for you I use and medical! Use the providers in our network, you can also contact us by fax for expedited coverage.. Directly through Blue Cross of Idaho True Blue Rx Gem H1350-024 ( HMO ) Idaho. Id available prenatal supplements, contraceptives, fluoride for children and tobacco aids! Period is the 12 months following your coverage effective Date financially responsible for services found to not! Knowing what ’ s ( FDA blue cross of idaho coverage recommendations and accepted medical practices Form no coverage of medications! Visiting CVS Caremark, you will be asked to register here are a few to! Amount you pay listed in the formularies also provide information regarding the following terms and Conditions of the Blue of... Coverage from the plan that is best for you, you may pay less for your plan the! Option II H1350-016 ( HMO ) plan has a $ 3,000 coverage limit plan & benefits menu clicking.. Copays, Blue Cross of Idaho partners with IngenioRx to provide Pharmacy benefits page coverage without interaction the. Nurse at no cost to you and your family self-administered medications, please visit the Specialty drugs..