Who do I notify for family status or address
changes?
Notify your Treasurer's office or personnel office on an enrollment/
change form of the following changes within 31 days of the event:
-
Marriage
-
Adoption
-
Qualified Medical Child Support Order
-
Child turns 19.
-
Child gets married.
-
Address or phone number change.
-
Special Provision: Newborns are covered at the moment of
birth ONLY if you enroll your new baby in our Plan within the 60 days
immediately following birth.
Your medical claim payments may be delayed or denied if you
do not notify your treasurer's office or personnel office. District
Contact
Do I have coverage while I am on vacation?
Yes. Emergency or Urgent Care claims away from home for plan members are
paid at 80% as if IN-NETWORK of usual and customary charges. When
traveling or attending college out of the local PPO network area, call the
national PPO network, Multiplan at 800-672-2140. Claims will be paid at the
in-network rate.
How do I know what is covered by the BCHP
plan?
Your BCHP Medical Benefits Handbook and Dental Benefits Handbook
explains who can be covered, how payments are made, how to file a claim and
other important information on how your Plan works. You may also call
Alliedat 800-288-2078 for dental and medical benefit questions. You
may contact
Caremark
at 1-866-498-2247 for prescription drug benefit
questions.
Traveling Abroad! Do You Need Medical Evacuation
Insurance?
Although some health insurance companies may pay "customary and
reasonable" hospital costs abroad, very few will pay for medical
evacuation back to the United States. Medical evacuation can easily cost
$10,000 or more, depending on your location and medical condition. One of
the main advantages of health and emergency assistance policies is that they
often include coverage for medical evacuation to the United States. BCHP
covers urgent and emergency care abroad, but not medical evacuation. If you
want medical evacuation back to the United States, you should consider
medical evacuation insurance for your trip.
Does my ID card work outside the USA?
Some medical providers in foreign countries may not accept your ID card,
particularly third world countries or providers in very rural areas. You
could be asked to pay for your care by cash or credit card. If this occurs,
you may file a claim for covered services with Allied for reimbursement. YOU
must get a DETAILED & itemized bill for the service with the
current rate of exchange -in English.
For prescription drugs, get a detailed receipt in English complete
with drug name, strength, etc. and submit the claim to
Caremark
for
reimbursement.
What is a Usual & Customary, U/C charge?
The amount usually charged by the majority of doctors, dentists or
providers in a geographic area for services. Because BCHP has a PPO network
of providers that have agreed to pre-negotiated fees for their service,
there is no "balance billing" or U/C charge. If you receive
service from an Out-of-Network provider, you are not protected from U/C.
Since there is no dental network, the dentist may charge you for U/C.
I'm a new employee. I do not have my ID card yet. How
do I get coverage?
Prescription drugs: You will need to pay the full price, but
reimbursement will be made to you after you receive your ID card. Send a
copy of your receipt with a direct reimbursement claim form to
Caremark.
Medical Claim: A provider may verify that you were hired and have
medical coverage with your school district by calling your employer's
office. When you receive your ID card, all verifications of benefits should
be made by calling Allied customer service at 800-288-2078.
What is the HIPAA?
It is a federal law that regulates how covered entities such as health
care providers and health plans, including the Butler County Health
Plan, may use and disclose protected health information ("PHI").
Many provisions of HIPAA become effective on April 14, 2003.
