While participating in FLEX, you can still access the network of SilverSneakers locations across the country. Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. Y0041_HM_15_23302 Accepted 10/04/2014, Keystone 65 Preferred Rx HMO Disenrollment Form You can call the Member Help Team to learn how to name your appointed representative. Blue Cross Blue Shield Global is a brand owned by the Blue Cross Blue Shield Association. Effective January 1, 2016, the hearing aid reimbursement is only available to certain Keystone 65 HMO employer group plans. In October 2011, Independence Blue Cross launched a private, charitable foundation the Independence Blue Cross (IBC) Foundation with a mission to transform health care through innovation in the communities it serves. For more information, please visit, https://www.globalfit.com. MDLIVE may not be available in certain states and is subject to state regulations. About GlobalFit Independence Blue Cross Foundation - Wikipedia However, please note that on weekends and holidays from February 15 through September 30, your call may be sent to voicemail. Use our Find a Doctor tool to locate network doctors, hospitals, and other medical facilities and services across the street or across the country. P.O. educate and encourage healthy behavior through active participation. When it refers to "plan" or "our plan," it means Keystone 65 Basic Rx HMO, Keystone 65 Select Rx HMO, Keystone 65 Preferred Rx HMO, Keystone 65 Focus Rx HMO-POS, Personal Choice 65 Rx PPO, Personal Independence Blue Cross is the leading health insurance organization in southeastern Pennsylvania. From October 15th through December 7th each year, anyone can make any type of change including adding or dropping Medicare prescription drug coverage. Please read these important instructions regarding requesting disenrollment from the plan. Independence Blue Cross has contracted with Inovalon, an independent company, to perform Personal Health Visits for Keystone 65 members and Personal Choice 65 members. There are exceptions that may allow you to disenroll from a Medicare Advantage plan outside of this period. The visit lasts about an hour and includes a detailed health assessment. MDLIVE does not replace the primary care physician, is not an insurance product and may not be able to substitute for traditional in-person care in every case or for every condition. Every year, Medicare evaluates plans based on a 5-Star rating system. 2019. Website last updated: 6/23/2016 Learn more Pharmacy policies Life is complicated. Prepare for visits and discussions with your doctor. Instead of paying full price, Independence members can find exclusive discounts on classes and times that fit their schedule. Enrollment in Independence Medicare Advantage plans depends on contract renewal. PDF Keystone 65 Rx Personal Choice 65SM Rx 2022 Formulary - MMITNetwork When should I fill out the disenrollment request form? Nearly 2 million SilverSneakers members are already enjoying the health benefits of physical activity, and you can be one of them. Health Information with WebMD Did you know Keystone 65 HMO and Personal Choice 65SM PPO members are eligible for SilverSneakers at no additional cost beyond their monthly premium? Each facilitys cost of care is evaluated using data from its Local Blue Plan. Y0041_H3909_PC_16_38300 Accepted 10/17/2015, Website last updated: 6/23/2016 You're eligible to receive the choice of a $50 gift card from an Independence Blue Cross preferred retailer when you complete a Personal Health Visit with no cost to you. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Health care professionals using the platform have the right to deny care if based on professional judgment a case is inappropriate for telehealth or for misuse of services. You can ask the nurse practitioner as many questions as you like. We are pleased to provide members like you with convenient online resources and a full range of innovative programs and services to keep you healthy and informed. Please note that on weekends and holidays from April 1 through September 30, your call may be sent to voicemail. Y0041_H3952_KS_16_31550 Approved 8/6/2015, Mail to: Independence Blue Cross would like to introduce you to the Member Help Team, our Medicare Customer Service program. App-based solution connects members to fitness studios, gyms, and trainers, Independence Blue Cross is first health insurer to offer new fitness benefit, Blue Cross Blue Shield Association Supports RSV Immunization for Newborns, Addressing Our Nations Maternal and Youth Mental Health Crises is Essential to Promoting the Health of America, Blue Cross Blue Shield Association Announces Brian Bauer as New Vice President of Application Solutions, Blue Cross and Blue Shield Companies Work to Advance Affordability Solutions to Protect Patients from Rising Health Care Costs, Blue Cross Blue Shield Association Partners with Boys & Girls Clubs of America to Address Youth Mental Health Crisis, Blue Cross and Blue Shield of Vermont Flood Support, Blue Cross and Blue Shield of Louisiana Offers Services to Members Affected by Hurricane Ida, Blue Cross Of Idaho And The Blue Cross Of Idaho Foundation For Health Commit To Expanding Health Equity Across Idaho, Blue Cross Blue Shield of Wyoming Announces New Board Member. In October 2011, Independence launched a private, charitable foundation the Independence Blue Cross Foundation. To file an appeal or grievance for your medical benefit coverage or your prescription drug coverage, contact Keystone 65 Customer Service at 1-800-645-3965 or Personal Choice 65 Customer Service at 1-888-718-3333; TTY/TDD users should call 711, 7 days a week, 8 a.m. to 8 p.m.; or you can complete and submit online theRequest for Medicare Prescription Drug Coverage Determination or the Request for Redetermination of Medicare Prescription Drug Denial. Welcome, and thanks for choosing Personal Choice 65SM PPO as your health plan in 2023! Wellness Tools The focus is on one goal being as healthy as possible. understand your condition and current health status; learn skills to keep yourself as healthy as possible; manage your symptoms and side effects of treatments; stay on track with your health care providers plan of care; transition between the hospital and home; cope with the emotional impact of your illness or condition; refer you to other plan programs or benefits-related resources available to you such as nutrition counseling or mental health services; find support groups and community resources. We carefully review independent performance and quality data before admitting any doctor, hospital, or specialty service provider into our network, so you can feel confident about your choice. Y0041_H3952_KS_16_38294 Accepted 10/17/2015, 2016 Personal Choice 65 PPO Star Ratings You can also call 1-800-MEDICARE (1-800-633-4227) anytime, 24 hours a day, 7 days a week for more information about trial periods. Blue Cross Blue Shield In a twist of regrettable irony, PBS Broadcasting . MDLIVE may not be available in certain states and is subject to state regulations. PDF Medicare Secondary Payer Overview Introduction - Centers for Medicare Independence Blue Cross is a leading health insurer in southeastern Pennsylvania. If you want Original Medicare, as described above, you may fill out the appropriate disenrollment form during a valid election period, sign it, and send it back to us at: Independence Blue Cross Non-tobacco rates apply to applications submitted during the six-month open enrollment or in a guaranteed issue situation. Medicare beneficiaries may also enroll in Keystone 65 HMO, Personal Choice 65SM PPO, or Select Option PDP through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. Medical Mutual of Ohio (MMOH) is an American mutual health insurance company. Connect with us on Facebook at facebook.com/ibx and on Twitter at @ibx. Philadelphia, PA 19101-3652. If youre looking for options outside the traditional fitness location, try SilverSneakers FLEX. GlobalFit Anywhere negotiates discounted fitness class rates and passes the savings to the member. Y0041_HM_15_23304 Accepted 10/04/2014, Personal Choice 65 Disenrollment Election Form Not a problem. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. You can make plan changes, such as requesting disenrollment, only at certain times during the year. Any disputes regarding these products and services may be subject to the plan grievance process. If you or your patient needs services that require preapproval/precertification, please call 1-800-ASK-BLUE. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Independence Blue Cross offers products through its subsidiaries Independence Hospital Indemnity Plan, Keystone Health Plan East and QCC Insurance Company independent licensees of the Blue Cross and Blue Shield Association. The ibxpress.com member website helps take the guesswork out of making important health decisions. To make the most of your health plan, below are resources and quick tips to get started: Use our Find a Provider tool to find in-network doctors, hospitals, and urgent care centers near you. Independence is an independent licensee of the Blue Cross and Blue Shield Association. For additional assistance, visit The Office of the Medicare Ombudsman. [1] Independence is the largest health insurer in the Philadelphia area, serving people in the region and seven million nationwide.[2]. You shouldn't fill out the appropriate disenrollment form if you are enrolling in a Medicare prescription drug plan. Designed exclusively for Medicare individuals, Healthways SilverSneakers Fitness Program is an exercise program for active older adults. Your State may have laws that provide more Medigap protections. GlobalFit Anywhere will donate the proceeds of these classes to local non-profits that are investing in the health and wellness of underserved communities in Pennsylvania and New Jersey. Personal Choice 65 offers PPO plans with a Medicare contract. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Sean Robbins Executive Vice President and Chief Corporate Affairs Officer Jennifer Vachon Executive Vice President, Business Operations Kari Hedges Senior Vice President, Market Solutions David Merritt Senior Vice President, Policy and Advocacy Lynn Merritt Senior Vice President, Chief Human Resources Officer Scott Nehs Download Frequently Asked Questions about Personal Health Visits Independence supports the Prostate Cancer Foundation during Prostate The Independence Blue Cross OTC benefit is underwritten by Keystone Health Plan East/QCC and is administered by Convey Health Solutions, Inc., an independent company. Applicants NOT enrolling during the six-month open enrollment period or in a guaranteed issue situation will be evaluated for tobacco usage and charged the corresponding tobacco or non-tobacco rates. Prescription drugs | FAQ | Independence Blue Cross (IBX) Blue Cross Blue Shield Companies Form Synergie Medication Collective, a What is extra help? MDLIVE and the MDLIVE logo are registered trademarks of MDLIVE, Inc. and may not be used without written permission. Cigna's Express Scripts And Big Blue Cross PBM In Major Deal - Forbes After youve joined the plan, you will receive the Evidence of Coverage in the mail. Call collect 1-804-673-1177 from outside the U.S. Blue Distinction Centers (BDC) met overall quality measures for patient safety and outcomes, developed with input from the medical community. The SilverSneakers fitness program is provided by Tivity Health, Inc., an independent company. Philadelphia Mayor S. Davis Wilson enrolled as the first member, and Independence Hall became the first employer group to purchase coverage. Drug formularies Members who have prescription drug coverage through Independence Blue Cross (Independence) are covered under one of several formulary-based prescription drug benefit programs. Membership in SilverSneakers is offered at no additional cost to members beyond their monthly premium. Request for Medicare Prescription Drug Coverage Determination, Request for Redetermination of Medicare Prescription Drug Denial. This program allows in-network providers to order select specialty medical benefit drugs for administration in the office. Not connected with or endorsed by the U.S. Government or the federal Medicare program. MDLIVE does not guarantee patients will receive a prescription. If you prefer to file a grievance through CMS, please complete the Medicare Complaint Form. The trick is to figure out what makes sense for you. No monthly membership required. document.write(new Date().getFullYear()) Independence Administrators is an independent licensee of the Blue Cross and Blue Shield Association, serving southeastern Pennsylvania.QCC Insurance Company and Independence Administrators are subsidiaries of Independence Blue Cross independent licensees of the Blue Cross and Blue Shield Association. Blue Meridian Partners is a pioneering philanthropic model for finding and funding scalable solutions to the problems that limit economic and social mobility for America's young people and families in poverty. Your Health Coach will work with you, your physicians, and your family to ensure your care is on the right track and you're getting the most out of the covered benefits and resources available to you. These programs are designed to provide physicians with a range of prescribing options while maintaining cost-effectiveness for Independence members. We will give a 30-day notice of a premium change. The person taking action on your behalf is called an appointed representative. Website last updated: 1/13/2016 COVERED PERSON means a Medicare beneficiary who is enrolled in Medicare Part A and Part B, made the appropriate payment in consideration for this Policy, and is eligible for benefits under this Policy. Personal Choice 65 PPO Health Plans | Independence Blue Cross Medicare The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. A Pioneering Philanthropic Model. If you need any help, please contact the Member Help Team. In addition to health care benefits, Independence Blue Cross offers specialized services and managed care through its affiliates and subsidiaries. QCC Insurance Company has the right to change premiums based on your attained age and the table of rate changes. We will give a 30-day notice of a premium change. Mailing addresses: For Keystone 65 HMO or Personal Choice 65 PPO: Independence Blue Cross Medicare Department PO Box 7799 Philadelphia, PA 19101-7799 For MedigapFreedom, MedigapSecurity, or Security 65: Independence Blue Cross PO Box 7330 Please note that on weekends and holidays from April 1 through September 30, your call may be sent to voicemail. We offer a full range of innovative benefits, programs and services to give our members the information, programs, and support they need to live healthy and stay healthy. Y0041_HM_15_23302 Accepted 10/04/2014, Personal Choice 65SM Rx PPO Disenrollment Form The formulary, pharmacy network, and/or provider network may change at any time. If you received your vaccine at a non-participating provider and paid out of pocket, you can use the following forms to apply for reimbursement. To file an appeal or grievance for your medical benefit coverage or your prescription drug coverage, contact Keystone 65 Customer Service at 1-800-645-3965 or Personal Choice 65 Customer Service at 1-888-718-3333; TTY/TDD users should call 711, 7 days a week, 8 a.m. to 8 p.m.; or you can complete and submit online theRequest for Medicare Prescription Drug Coverage Determination or the Request for Redetermination of Medicare Prescription Drug Denial. Prescription Drug Plans | Medicare Part D | Independence Blue Cross (IBX) Y0041_HM_15_23302 Accepted 10/04/2014, Personal Choice 65SM Medical-only PPO Disenrollment Form It is the oldest and largest health insurance company based in Cleveland, Ohio, and serves more than 1.6 million customers. All Rights Reserved. Telemedicine is provided by MDLIVE, an independent company. For more information on Keystone 65 Focus Rx HMO grievances, please reference Chapter 9, Section 10 on page 179 in your EOC or click on the link below. Philadelphia PA 19101-7799, Personal Choice 65 PPO Change Form Members | Independence Administrators (IBXTPA) The formulary, pharmacy network, and/or provider network may change at any time. Independence Blue Cross Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania. Pay-as-you-go To avoid any unexpected expenses, you may want to contact us to make sure you've been disenrolled before you seek medical services outside of the plan's network. Your Medicare Advantage plan will not change in any way because of your health assessment. If you want to talk with a health professional about a health-related issue, or if you have complex health care needs and require assistance, please contact a case manager by calling 1-888-234-2393. Download Information on Advance Directives. OptumRx, an independent company, provides pharmacy benefit management services for Independence Administrators. For additional information from the Centers for Medicare and Medicaid Services (CMS) visit http://www.medicare.gov. Contact us for more information or a copy of the Advance Directive form. [1] Independence is the largest health insurer in the Philadelphia area, serving people in the region and seven million nationwide. What is the Specialty Pharmacy Program? The effective date of the disenrollment from the MA plan is the first day of the month following the date the disenrollment request is received thus, disenrollment requests received by MA organization in January are effective February 1; those received from February 1 through February 14 are effective March 1. Pharmacy Benefit Managers - PBMs - Healthcare Medical Pharmaceutical Keystone 65 Select Medical-only HMO Grievances Hoover's. The Army supports singer Mickey Guyton in an Independence Day concert despite the BLM celebratory song she wrote blaming 'land of the free.'. Keystone 65 Focus Rx HMO Grievances For additional assistance, visit The Office of the Medicare Ombudsman. *The products and services indicated with an asterisk above are neither offered nor guaranteed under our contract with the Medicare program. PHILADELPHIA, Aug. 9, 2011 /PRNewswire/ -- Two of the nation's largest not-for-profit Blue health insurers, Independence Blue Cross (IBC) and Blue Cross Blue Shield of Michigan. Member Resources | Medicare | Independence Blue Cross (IBX) To learn more, visit www.ibx.com. The Care Management and Coordination (CMC) department will evaluate your request and will notify your office once a decision has been reached for those cases that require clinical review. July 12 In a move that signals Blue Cross Blue Shield plans are getting increasingly serious about driving down the cost of prescription drugs, five major Blues affiliates on June 22 launched a startup company that aims to "offer innovative medication solutions to patients, providers and customers." To access your member services, please visit your BCBS company. About us Careers Newsroom IBX Foundation IBX Innovation, Facebook Instagram Twitter LinkedIn Youtube Pinterest. Prescription drug formularies A formulary is a list of prescription drugs covered by the plan. By 1958, it employed 600 people and contracted with 94 hospitals. Philadelphia PA 19101-7799. TruHearing is a registered trademark of TruHearing, Inc., an independent company. The Independence Blue Cross OTC benefit is underwritten by Keystone Health Plan East/QCC and is administered by Convey Health Solutions, Inc., an independent company. If you have someone appealing our decision for you other than your physician, your appeal must include an Appointment of Representative form. Benefits underwritten by QCC Insurance Company, a subsidiary of Independence Blue Crossindependent licensees of the Blue Cross and Blue Shield Association. At Independence Blue Cross, we believe that your good health is the result of good teamwork, so we want to make sure that your doctor has up-to-date information about your health status. LabCorp is the primary provider of laboratory services for Independence Administrators.
Recapitulation Theory Of Play, Top 10 Tax Saving Mutual Funds, Articles W