Welcome to Enhanced Care PPO (ECP), your new and improved health care plan from Blue Cross Blue Shield of Michigan for non-Medicare members. ECP has the same comprehensive benefits you expect from Blue Cross, plus new benefits such as special support services and unlimited visits to your network primary care physician and specialists.
What is an enhanced care PPO (ECP)?
Non-Medicare Plan Type PPO Availability All states MORE ABOUT THIS PLAN 2022 Plan details See what's covered and how much you'll pay. SHOW COST CHART Individual monthly contribution $17 Family monthly contribution $34 PCP office visits $10 per visit, in network Enhanced Care PPO Videos VIDEO Getting to know your Enhanced Care PPO health plan
What is blue Medicare PPO enhanced (PPO)?
Beginning January 1, 2019, the Enhanced Care PPO (ECP) plan will be the nationwide health plan available to all non-Medicare Trust members. The plan will provide unlimited Primary Care Physician (PCP) and Specialist Physician office visits, …
What is a Medicare PPO plan?
Welcome to Enhanced Care PPO (ECP), your new and improved health care plan from Blue Cross Blue Shield of Michigan for non-Medicare members. ECP has the same comprehensive benefits you expect from Blue Cross, plus new benefits such as special support services and unlimited visits to your network primary care physician and specialists.
What is a non-Medicare ECP plan?
The Enhanced Care PPO (ECP) plan is the primary plan for non-Medicare Trust members. This nationwide health plan provides unlimited primary care physician (PCP) and specialist physician office visits at a flat dollar copay, as well as other helpful programs.
What is BCBS PPO?
Offered through Blue Cross Blue Shield (BCBS), this plan offers more benefits while keeping the same great PPO network of doctors and hospitals.#N#In addition to unlimited access to PCP and specialist physician office visits at a flat dollar copay, this plan will feature personalized, convenient resources to assist you in navigating the health care system. You will have access to a personal, dedicated health guide who can help you find hospitals and doctors, answer questions about what’s covered under the plan, assist you with any provider billing questions, as well as connect you to a supporting team of clinical staff, care managers, and new specialized programs.
What is ECP plan?
ECP Plan: Base Plan for Non-Medicare Members in 2019. Beginning January 1, 2019, the Enhanced Care PPO (ECP) plan will be the nationwide health plan available to all non-Medicare Trust members. The plan will provide unlimited Primary Care Physician (PCP) and Specialist Physician office visits, as well as other helpful programs.
Can PCP be your home?
If specialist coverage is new to you or if you’re not sure when to see a specialist, talk to your doctor. You and your PCP may decide a health issue or symptom would benefit from more expert care and your PCP can direct you to see a physician who specializes in the related practices.
Can a PCP direct you to a doctor?
You and your PCP may decide a health issue or symptom would benefit from more expert care and your PCP can direct you to see a physician who specializes in the related practices. Additionally, new with this plan, you have access to a 24-hour nurse line.
Can you attend a webinar in person?
You may be invited to attend a teleconference or webinar in place of, or in addition to, an in-person meeting. This is a great alternative if you are not able to attend an in-person meeting or do not have the option of an in-person meeting where you reside.
Trust Benefits for Non-Medicare Members
Watch this video to learn more about how your UAW Retiree Medical Benefits Trust coverage works when you are not enrolled in Medicare.
More Benefits
Offered through Blue Cross Blue Shield (BCBS), the ECP plan offers greater benefits than other plan options while providing access to a national network of PPO doctors and hospitals. In addition to unlimited access to PCP and specialist physician office visits at a flat dollar copay, this plan features personalized, convenient resources to assist you in navigating the health care system.
Cost Share
Before reviewing more details on your available plan options, it’s important to understand all Trust provided plans have copay and cost share elements.
Blue Medicare PPO Enhanced (PPO) Part-C Premium
Blue Cross and Blue Shield of North Carolina plan charges a $0.00 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.
H3404-003 Part-D Deductible and Premium
Blue Medicare PPO Enhanced (PPO) has a monthly drug premium of $29.00 and a $0.00 drug deductible. This Blue Cross and Blue Shield of North Carolina plan offers a $29.00 Part D Basic Premium that is not below the regional benchmark.
Blue Cross and Blue Shield of North Carolina Gap Coverage
In 2022 once you and your plan provider have spent $4430 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 25% for prescription drugs unless your plan offers additional coverage.
Premium Assistance
The Low Income Subsidy (LIS) helps people with Medicare pay for prescription drugs, and lowers the costs of Medicare prescription drug coverage. Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance.
Annual Notice of Change (ANOC)
This document (the “Annual Notice of Change”) includes any changes in coverage, costs, or service area between plan years.
Plan Specific Documents
This document provides some of the features of this plan. For a complete list of benefits, see your Evidence of Coverage.
24-Hour Nurse Advice Line
One of the benefits of being a WellCare member is our 24-Hour Nurse Advice Line. Our nurses will give you answers to your medical questions and help you decide whether to see your doctor or go to the emergency room. Nurses are available 24 hours a day, seven days a week at 1-800-581-9952. (TTY users dial 711 .)
What is the premium for Blue Cross and Blue Shield of North Carolina?
Blue Medicare PPO Enhanced (PPO) has a monthly drug premium of $47.00 and a $0 drug deductible. This Blue Cross and Blue Shield of North Carolina plan offers a $47.00 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0 this Premium covers any enhanced plan benefits offered by Blue Cross and Blue Shield of North Carolina above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $47.00. The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.
How much is Blue Medicare PPO premium?
Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The Blue Medicare PPO Enhanced (PPO) medicare insurance offers a $16.70 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $24.20 for 75% low income subsidy $31.80 for 50% and $39.40 for 25%.
What is Blue Medicare PPO Enhanced?
This can be a extremely nice safety net. Blue Medicare PPO Enhanced (PPO) is a Local PPO.
What is a PPO plan?
A preferred provider organization (PPO) is a Medicare plan that has created contracts with a network of "preferred" providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network.
Does Medicare cover lower tier drugs?
Drugs in lower tiers will usually cost less than those in higher tiers. By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price. Drug Tier.
Can you get medical care outside of the network?
You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate . Blue Cross and Blue Shield of North Carolina works with Medicare to provide significant coverage beyond Part A and Part B benefits.
Does Medicare cover hospice care?
With Medicare Advantage Plans you are always covered for urgently needed and emergency care. Plus you receive all of the benefits of Original Medicare from Blue Cross and Blue Shield of North Carolina except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.
What is a PPO plan?
A Medicare PPO Plan is a type of. Medicare Advantage Plan (Part C) A type of Medicare health plan offered by a private company that contracts with Medicare. Medicare Advantage Plans provide all of your Part A and Part B benefits, excluding hospice. Medicare Advantage Plans include: Health Maintenance Organizations.
What is a health care provider?
health care provider. A person or organization that's licensed to give health care. Doctors, nurses, and hospitals are examples of health care providers. , or hospital in PPO Plans. Each plan gives you flexibility to go to doctors, specialists, or hospitals that aren't on the plan's list, but it will usually cost more.
What is the difference between Medicare and Original Medicare?
Original Medicare. Original Medicare is a fee-for-service health plan that has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance). After you pay a deductible, Medicare pays its share of the Medicare-approved amount, and you pay your share (coinsurance and deductibles).
What is covered benefits?
benefits. The health care items or services covered under a health insurance plan. Covered benefits and excluded services are defined in the health insurance plan's coverage documents. than Original Medicare, but you may have to pay extra for these benefits. Check with the plan for more information.
Is Medicare a PPO or Advantage?
Most Medicare services are covered through the plan. Medicare services aren’t paid for by Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage. offered by a private insurance company. PPO Plans have network doctors, other health care providers, and hospitals. You pay less if you use doctors, hospitals, ...
Do you pay less if you use a hospital?
You pay less if you use doctors, hospitals, and other health care providers that belong to the plan's. network. The facilities, providers, and suppliers your health insurer or plan has contracted with to provide health care services. . You pay more if you use doctors, hospitals, and providers outside of the network.
