All rights reserved. In less than a minute see if your income and household size qualify you for the Essential Plan or other free or low cost plans. Coverage for eligible faculty and staff members is effective the first of the month following your date of appointment or on the date of appointment if it occurs on the first of the month. Get care safely from home with telehealth services through your in-network provider or 24/7 telemedicine through MDLIVE. Lets take a closer look at the different types of plans offered by Excellus and how much they may cost in different areas. Contact numbers are available here. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Excellus offers both HMO and PPO plans at a variety of price points, including plans with no premiums in some counties. What online tools are available to help me manage my membership? Don't have your card handy? 5 Star Plans not available in all counties. Enrollment for 2022 coverage continues through the end of the year. When health care is more accessible and affordable. Terms of Use | Web Privacy Policy | Accessibility Statement. Stay informed on vaccines, testing coverage and more. The Excellus National Dental Network gives you access to significantly more dental providers nationwide through the new National Dental GRID+ network. If you have a question or need help finding or completing a document, our contact page will point you in the right direction. You can review the prescription drug lists covered by our plans at ExcellusBCBS.com. What do I pay for after I hit my deductible? Dr. Taxpayers are not required to include a Form 1095-B when filing their taxes. We can help you get coverage. PPOs work a lot like HMOs, but youll have even more flexibility. How do I help a loved one find the right Medicare plan? "We will continue to automatically extend consumers' public program coverage for the duration of the federal emergency, but Qualified Health Plan coverage must be renewed for 2023. There are two times when you can buy health insurance: Open Enrollment and Special Enrollment Periods. NY State of Health Announces Affordable Health Plan Choices for 2022 You may be able to join or switch plans under special circumstances that grant a Special Election Period. Blue Select, College Blue, Dental Blue Options, Federal Employee Program, Pediatric Dental, SimplyBlue Plus Dental, & SmileSaver Search Local Dentists There are seven insurers offering plans on the Small Business Marketplace in 2023: *Also offer SBM-certified Healthy NY Plans. div.card-col-content.card-col-gutters h5, Healthline Media does not recommend or endorse any third parties that may transact the business of insurance. Accountable Health Partners (AHP) Find providers and estimate costs Health care when traveling Special extended health care coverage for certain adult children through age 29 COBRA Transparency in Coverage Final Rules Frequently asked questions Answers to your health care plan questions Get in-depth information on definitions, coverage, and more. Want to learn about Medicare? Each year, we provide thousands of hours worth of in-person and online learning & professional development programs. Get expert advice in-person at one of our Resource Center locations on W. Ridge Road in Rochester and S. Warren Street in Syracuse. Some forms may not apply to your coverage and benefits. PDF Understanding your PPO Dental Plan - Excellus BCBS Dental plans comparison chart Printer-friendly chart }); You may also want to inquire as to whether the plan has a telemedicine program that provides 24/7 access to a doctor by phone or video chat when you have a minor health issue and can't see your physician. Our two dental plans, the Traditional Plan and Medallion Plan, are administered by Excellus BlueCross BlueShield and offer you coverage for your dental needs. An interactive online benefits decision tool that will assist you in understanding your benefit options and enable you to make an informed decision when making your benefit elections. margin: 0 20px 0 0; Log in with your username and password to access forms, authorizations, news and more. display:none !important; In some cases, consumers will have to select a new plan when they renew their coverage for 2023. } PPOs have a network, but you can get coverage for care outside the network. -ms-border-radius: 6px; Our website services, content, and products are for informational purposes only. All rights reserved. Plans include Part D coverage as well as coverage for extra services like vision care, hearing exams, and optional dental care. Plan pays 100% of in-network negotiated rates, no deductible, **Covered at 50%, subject to orthodontia lifetime maximum Copyright 2023, Excellus BlueCross BlueShield, a nonprofit independent licensee of the Blue Cross Blue Shield Association. How do Medicare Advantage Plans work? The University reserves the right to modify, amend, or terminate the Plans at any time, including actions that may affect coverage, cost sharing, or covered benefits, as well as benefits that are provided to current and future retirees. However, Excellus doesnt offer standalone Part D plans. Once youre enrolled in Medicare, you can change your Medicare coverage during the Annual Election Period from October 15 to December 7. Consumers in the counties served by these insurers will continue to have a choice of three or more insurers offering dental plans. Dental coverage is available for adults and families in some QHPs or through a stand-alone dental plan. Here are facts to help you decide. See our Privacy Policy for how we use information. margin: 15px auto; Any premium for a Medicare Advantage plan will be in addition to the premium you pay for Part B. I would like to receive emails from Excellus BCBS, such as Wellness and Health newsletters and more. If the more expensive procedure is chosen by you or your Dentist and is not medically necessary, you must pay the difference between the plans payment and the amount billed by the Dentist. Medicare provides coverage if you are 65 or older or have a disability, regardless of income. $(this).prev( "div" ).find(".card-col-content").html(cur_announcement); Copyright 2023, Excellus BlueCross BlueShield, a nonprofit independent licensee of the Blue Cross Blue Shield Association. Select plans also offer a $500 flex card to use toward out-of-pocket dental, hearing, or vision expenses. Ac., CYT, Syracuse, NY: Medicare BlueEssential (PPO), $7,550 in network, $11,300 in and out of network, $5 in network, 30% coinsurance out of network, $50 in network, 30% coinsurance out of network, $6,000 in network, $9,300 in and out of network, Rochester, NY: Medicare Blue Choice Value (HMO), $40 in network, 30% coinsurance out of network. Coinsurance is similar to copay. Find information related to our contract and credentialing processes. This expansion allows for more providers to be in-network and may provide lower out-of-pocket costs. The Marketplace will offer the following eight dental plans on the individual Marketplace: Delta Dental Dentcare Empire HealthChoice Dental BlueCross and Empire Health Choice Dental Blue Cross BlueShield* All rights reserved. border: none !important; Benefits will be provided for the procedure carrying the lesser allowable expense, provided that procedure meets acceptable dental standards, subject to medical necessity. .main-content-card { This benefit covers 100% of preventive dental services, like cleanings, x-rays, and bitewings, as well as more extensive services like restorative care or major procedures up to a $1,000 annual allowance. NY State of Health Announces 2023 Health and Dental Insurance Options 807 Spring Forest Rd, Ste 600, Raleigh, NC 27609. Were here to support you in all things related to working at the University of Rochester. Excellus BlueCross BlueShield is an HMO plan and PPO plan with a Medicare contract. All 12 insurers that offered Qualified Health Plans last year will offer them again in 2023. box-shadow: 0 0 0 1px rgb(0 0 0 / 10%), 0 2px 3px rgb(0 0 0 / 20%); Health insurers are no longer required to mail Form 1095-B to their members. Use the Find a Dentist tool to search for dentists in the Excellus network, choosing Dental Blue Options when it asks you to select your plan. To schedule your appointment. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. In 2023, Healthfirst and Independent Health will no longer offer plans on the SBM. Your exact services covered are based on the plan you choose, but all Excellus plans offer: Coverage, premiums, deductibles, and other out-of-pocket costs may vary from plan to plan. New Enhanced Dental Coverage. download our mobile app today! Knowing you've got the most trusted coverage during the moments that matter most. Other plans might be available in more places, but the price will vary based on your location. With access to a network of more than 13,000 other doctors, urgent care centers, hospitals and specialists, we have kids covered. Star Ratings are released annually and are based on member satisfaction, plan details, and overall performance. Yes! Frequently Asked Questions and Helpful Resources, Excellus BCBS Member Benefits andDetails. Both systems allow you to make payments, view your payment history, verify enrollment, access all previous bills and correspondence, and set up automatic debit. "NY State of Health continues to be a critical resource throughout the COVID-19 public health emergency, providing over 6.7 million New Yorkers with comprehensive, affordable coverage," NY State of Health Executive Director Danielle Holahan said. For example: If your coinsurance on a $100 bill is 15%, you pay $15 and we pay the rest. margin: 0 20px; See our Privacy Policy for how we use information. When it comes to choosing the right Medicare coverage, it's important to understand your options. } Let's get started! That's Medicare that cares back. Consumers in the counties served by these insurers will continue to have a choice of three or more insurers offering dental plans. Coverage for Residents and Fellows is effective the date of hire or appointment. Enrollment in Excellus BlueCross BlueShield depends on contract renewal. Take these important steps to learn about Medicare and see what you have to do now to prepare for enrollment. Submit a complaint about your Medicare plan at www.Medicare.gov or learn about filing a complaint by contacting the Medicare Ombudsman. Health Maintenance Organization (HMO) (n.d.). By Phone:For an immediate response, call the number on your Member Card for personalized care. Any deductible, copay, coinsurance or payment for covered services goes towards your out-of-pocket maximum. Make sure youre getting the most value out of your health plan by creating an account online at. PROSPECTIVE MEMBERS Group or Individual: PPO/EPO Panels Managed Care/Comprehensive/Select plans Discount Plan Healthcare Exchange (ACA): Find a Dentist Telemedicine/Telehealth 24/7 Nurse Line Contact Us Caregiver Support Medicare Star Ratings Check Drug Costs Blue365 Discounts Exercise with Silver&Fit 24/7 Access to Your Plan View member cards, benefits and claims, and more! When you can buy or change your health insurance all depends on the plan you qualify for. Generally, there are rules about when youre able to see out-of-network providers. Understand your options, learn more about your coverage, watch a Medicare plan highlight video, and set up a 1-on-1 appointment with a Medicare expert to get your questions answered. div.card-col-content.card-col-gutters h4 { Your eligibility forNew York State or federally-sponsored programs, financial assistance, or tax credits is determined by your household income and size compared to the Federal Poverty Level and other requirements. Retirees are billed quarterly for their share of the premium. Styles and script for Announcement on Dashboard page What Are the Advantages and Disadvantages of Medicare Advantage Plans? MEMBERS You can login to search providers in your plan or just enter your plan group number in the login box to the right. Excellus Medicare Advantage plans are offered to New York residents at multiple price points. This chart provides only a summary of the main features of the plans. Choose to enroll online, by mail when you order an enrollment kit, or by phone. For more information or to apply, call 1-800-234-4781, TTY: 1-800-662-1220 or visit, Bronze, Silver, Gold & Platinum Health Plans. Excellus offers Medicare Advantage plans in a few different formats and at multiple price points. The Star Rating is based on information collected from actual members like you, clinicians, and Medicares comprehensive monitoring process. Login | Providers | Excellus BlueCross BlueShield from 8 a.m. 8 p.m., and Fri. 9 a.m. - 8 p.m. If you reach your deductible, you may have a copay for some services and coinsurance for others. There are steps consumers can take now to prepare to renew coverage. In certain counties, Facilitated Enrollers are available by appointment. Blue Select Family Dental Plan | Excellus BlueCross BlueShield Visit our. Dental Providers: If you need assistance navigating our new experience (registration help, managing user access, etc. Get care safely from home with telehealth services through your in-network provider or 24/7 telemedicine through MDLIVE. display: block; Originally enacted through the American Rescue Plan Act (ARPA) and extended in August through the Inflation Reduction Act, these enhanced subsidies provide New Yorkers, with an average of $1,450, to lower the cost of their monthly premium and are also available to higher-income individuals.