Michigan Public School
Employees Retirement System
2013 Updates
Blue Cross Blue Shield of Michigan is a nonprofit corporation and independent licensee of the Blue Cross and Blue Shield Association.
Today’s Discussion
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Impacts of Passing of Senate Bill 1040
LivingWell Health Assessment
Turning age 65
Medicare Plus Blue Group Highlights
Top Tips to Avoiding the Emergency Room
Using the bcbsm.com/mpsers website
Questions and Answers
Impacts of Passing of Senate Bill 1040
• Premium Increase Effective 1/1/2013 for BCBSM
– Non-Medicare Retirees
• Currently pay an amount equal to Medicare Part B premium.
• The retiree health care premium share will be 20% of the total.
– Non-Medicare Spouses and Other Dependents
• Currently pay an amount equal to Medicare Part B premium.
• The dependent health care premium share will be 20% of the
total.
Impacts of Passing of Senate Bill 1040
• Premium Increase Effective 1/1/2013 for BCBSM
– Medicare Retirees
• Currently pay $12.
• The retiree health care premium share will be:
– 10% if the retiree is Medicare eligible and is enrolled in MPSERS
coverage on 1/1/2013.
– 20% if the retiree is Medicare eligible after 1/1/2013 or enrolls in
MPSERS coverage after 1/1/2013.
– Medicare Spouses and Other Dependents
• Currently pay $12.
• The dependent health care premium share will be:
– 10% if the dependent is Medicare eligible and is enrolled in MPSERS
coverage on 1/1/2013.
– 20% if the dependent is Medicare eligible after 1/1/2013 or enrolls in
MPSERS coverage after 1/1/2013.
Impacts of Passing of Senate Bill 1040
• Premium Increase Effective 1/1/2013 for Dental/Vision
– All Retirees, Spouses, and Other Dependents
• Currently pay 10%.
• The Dental/Vision premium share will be:
– 10% if the covered participant is 65 or over and enrolled in
MPSERS coverage on 1/1/2013.
– 20% if the covered participant is not both 65 and enrolled in
dental/vision coverage on 1/1/13.
LivingWell Program Updates
• Health Assessments were mailed in midOctober 2012 and are due by December
1st 2012 to qualify for the program for
2013.
When you become Medicare-eligible
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You become eligible for Medicare when you
reach age 65 or become permanently disabled.
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Be sure to enroll in both Parts A and B of
Medicare. Part B is required for enrollment in
Medicare Plus Blue Group PPO.
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Blue Cross will send you a letter 90 days prior to
your 65th birthday requesting your Medicare
information. Complete the letter and return
timely for Medicare Plus Blue Group enrollment.
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Store your red, white and blue Medicare card in
a safe place. You will only use your Medicare
Plus Blue Group ID card once you are enrolled.
Medicare Plus Blue Group Highlights
• Medicare Parts A and B combined with your
Retirement System coverage
• One BCBSM ID card
• One toll-free telephone number and
dedicated member services center
• Choose from a nationwide network of
providers or use any provider who accepts
Original Medicare
• Preventive services are covered
• Providers receive one combined payment
Top Tips to Avoid the Emergency Room
1. Establish a relationship with your physician.
2. Complete a personal medical record for each
member of your family and keep it handy as a
quick reference.
3. Call your physician for advice if you have an
injury or illness that requires immediate
attention.
4. Consider if a visit to your physician or an
urgent care facility might be an appropriate
place to go for immediate treatment of
conditions that are not life-threatening.
Top Tips to Avoid the Emergency Room
5. For conditions that are not life-threatening and
do not need immediate care, try to get a sameday or next-day appointment with your doctor.
6. Establish a plan with your family and physician
for what to do in emergency situations.
7. Use your physician or an urgent care center for
non-emergency conditions such as colds, flu,
minor burns, fever, sprains and sore throats.
8. See your physician for regular checkups to
prevent or detect conditions early.
Is there any advantage to having two
supplemental insurance policies?
• If you are enrolled in Medicare Plus Blue Group
PPO, there is no reason to purchase an
additional supplemental insurance plan (i.e.,
Medigap Plan)
• Medicare will only reimburse one plan and
Medicare Advantage is primary
Hearing Benefit
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Every 36 months
Deductible and coinsurance apply
Audiometric exam
Conformity test
Visit any hearing provider that will bill insurance for
the service
• First time purchaser must see doctor
• Two hearing aids are covered when purchased on the
same day
Coverage for Flu Shot/Shingles
Non-Medicare
Medicare
Flu Shot
Not Covered
Covered at
100%
Shingles
Vaccine
Not Covered
Not covered
under Medical
coverage
2012 Cost Sharing
Deductible
Coinsurance
NonLivingWell
$500.00
10%
Coinsurance $800.00
Out-of-Pocket
Maximum
LivingWell
$400.00
10%
$700.00
Your New Medicare Advantage
Identification Card
• Arriving in December 2012
• Each individual enrolled in the MA plan still gets
their own card with their own name on it
• Old Prefix – XYO; New Prefix – XYL
• Phone numbers removed from back of card per
CMS mandate
Using bcbsm.com/mpsers
Using bcbsm.com/mpsers
Using bcbsm.com/mpsers
Go Green!
Linking to Member Secured Services
Member Secured Service Registration
Locating Providers
Locating Providers
Contact us
• Customer Service
1-800-422-9146
• Dedicated web site
bcbsm.com/mpsers
• To find a provider outside of Michigan
1-800-810-BLUE (810-2583)
Helpful Information
• To contact our 24-hour Nurse Hotline
1-800-775-2583
• To find an Urgent Care Facility
1-800-422-9146
Or visit our website at
www.bcbsm.com
• Questions?