The Excellus National Dental Network gives you access to significantly more dental providers nationwide through the new National Dental GRID+ network. Common Questions & Helpful Resources The information you're accessing may not be provided by Excellus BCBS. If you're buying or renewing health insurance, you should ask four questions before selecting a plan:, Make sure your medicationsare covered by the insurer. Frequently Asked Questions and Helpful Resources, Excellus BCBS Member Benefits andDetails. Contact numbers are available here. /* Reducing "Dismiss" action button z-index less than Main Navigation */ Terms of Use | Web Privacy Policy | Accessibility Statement. There are two times when you can buy health insurance: Open Enrollment and Special Enrollment Periods. If I'm an Excellus BCBS member, can I make changes to my coverage? Limitations and exclusions can relate to number of visits, type or number of procedures, or age limits. $( ".entry-content" ).each(function() { Were looking for talented, skilled, and dedicated professionals to join us as we learn, discover, heal, and create. Generally, there are rules about when youre able to see out-of-network providers. 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* 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. Visit our. Enrollment has increased across all marketplace programs since April 2021, when the state began implementing ARPA tax credit and Essential Plan (EP) enhancements. margin-top: 15px; Our dedicated customer service unit will be happy to assist you at 866-891-2804. To schedule yours, call 1-888-576-6542. Some plans only cover certain states or even ZIP codes. 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. Don't have your card handy? This is the most you could ever pay in a year on covered health care services, excluding your monthly premium. Excellus BlueCross BlueShield is an HMO plan and PPO plan with a Medicare contract. Dental coverage is available for adults and families in some QHPs or through a stand-alone dental plan. } Income verification for the last four weeks. Excellus. Any information entered will be lost. You can make a payment online or view address information to mail your bill. That's Medicare that cares back. } Consumers in the counties served by these insurers will continue to have a choice of two or more insurers offering SBM-certified plans. 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. We're here to help you every step of the way with confidence. $50 individual/$150 family; applies to classes II, IIA, and III, $1,000 applies to classes II, IIA, and III, $2,000 applies to classes II, IIA, and III. What Are the Advantages and Disadvantages of Medicare Advantage Plans? View member cards, benefits and claims, and more! Let's get started! Choose your Medicare plan with confidence from the company your neighbors have trusted for over 85 years. If you want Part D coverage through Excellus, youll need to purchase a Part C plan. Health Maintenance Organization (HMO) (n.d.). Excellus divides its coverage area into five regions: The exact plans available to you will depend on your specific region, county, and ZIP code. Dental premiums are billed through Lifetime Benefit Solutions (LBS). Are you sure you want to leave? } You will have 30 days to pay the invoice. Health insurers are no longer required to mail Form 1095-B to their members. Your will also have access to a network of more than 13,000 other doctors, urgent care centers, hospitals and specialists when needed. If youre turning 65, you can enroll in Medicare from the period that extends 3 months before to 3 months after the month of your 65th birthday. All rights reserved. What You Need to Know About Medicare Part C, Sign Up for Medicare: How and When to Enroll in Medicare. What do I pay for after I hit my out-of-pocket maximum? Do not use to submit prescription drug services. } You may be able to join or switch plans under special circumstances that grant a Special Election Period. Knowing you've got the most trusted coverage during the moments that matter most. 807 Spring Forest Rd, Ste 600, Raleigh, NC 27609. .entry-content .btn { Medical Provider Registration | Providers | Excellus BlueCross BlueShield Medical Provider Registration Medical service providers and administrators are allowed to create an individual practice account or register a hospital, group practice or facility. The 12 insurers offering Qualified Health Plans* in 2023 are: Please note: Some individual products will be discontinued as of 12/31/22. Get expert advice in-person at one of our Resource Center locations on W. Ridge Road in Rochester and S. Warren Street in Syracuse. Lets get started! Links marked with an (external site) icon indicate you're leaving ExcellusBCBS.com. Have a question or need help finding coverage? Enrollment in Excellus BlueCross BlueShield depends on contract renewal. Copyright 2023, Excellus BlueCross BlueShield, a nonprofit independent licensee of the Blue Cross Blue Shield Association. Consumers in the counties served by these insurers will continue to have a choice of three or more insurers offering dental plans. See our Privacy Policy for how we use information. However, nonparticipating dentists are not obligated to accept Excellus BCBSs allowed amounts as payment in full and will balance bill any amount in excess of Excellus BCBSs allowed amounts. vertical-align: middle; Dr. Deborah Simmers is a graduate of the East Carolina University (ECU) School of Dental Medicine and is a member of the American Dental Association, North Carolina Dental Society, and Old North State Dental Society. Find your Medicare Plan to learn about the other benefits available to you, such as over-the-counter allowances and Silver&Fit. For Medicare, refer to our Medicare Advantage Timeline for specifics on when you may switch your Medicare coverage. PPOs work a lot like HMOs, but youll have even more flexibility. The Star Rating is based on information collected from actual members like you, clinicians, and Medicares comprehensive monitoring process. Chat is available from Mon - Thurs from 8am 7pm, and Fri 9am - 7pm. Find a plan that works in your service area. We use cookies and other technologies to optimize site functionality, analyze website traffic, and share information with social media, advertising, and analytics partners. We use cookies and other technologies to optimize site functionality, analyze website traffic, and share information with social media, advertising, and analytics partners. Resources Health Insurance Plans for Excellus BCBS Providers. Areas served include central New York, eastern New York, and the Greater Rochester area. Excellus is a division of Blue Cross Blue Shield based in Rochester, New York. We're here to discuss your needs, answer questions about plans and help you and your employees embrace their health and well-being. The information you're accessing may not be Medicare-specific and/or provided by Excellus BCBS. Make sure youre getting the most value out of your health plan by creating an account online at. 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. Its easy to use and gives you options for services based on your current plan. To obtain other forms not listed here, please contactCustomer Services. Our Medicaid plans sponsored by New York State provide free or low-cost health insurance for individuals and families who meet NYS income eligibility requirements. Excellus offers Medicare Advantage plans in a few different formats and at multiple price points. display: none; You can learn more about how we ensure our content is accurate and current by reading our. Ask if the plan covers emergency care anywhere in the world. Links marked with an (external site) icon indicate you're leaving ExcellusBCBS.com. What online tools are available to help me manage my membership? Consumers should pay close attention to any notices received during this time of the year and be prepared to take actions necessary to assure that they maintain coverage into 2023. We can help you get coverage. Each year, Medicare plans earn ratings on a one-to-five scale, with one star representing poor performance and five stars representing the highest quality rating a health plan can earn. A PPO is another common type of insurance plan. Implants (limited coverage requires preauthorization). 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. When applying for health insurance, be prepared with the following information: Outside the annual open enrollment period (February 1-October 31), you may qualify to buy or change your health insurance coverage if you experience certain life events, within 60 days in most cases. Youll also be able to see providers outside of your network in an emergency situation no matter what type of HMO you have. *Contact Excellus BlueCross BlueShield for the full list of covered services. Why are we asking how many people live in your household? Consumers who enroll in a QHP between November 16, 2022 and December 15, 2022 will have coverage starting January 1, 2023. Let us help you find the right plan. 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. Excellus BlueCross BlueShield is an HMO plan and PPO plan with a Medicare contract. This chart provides only a summary of the main features of the plans. **Enrollment in the Medallion Plan and orthodontia treatment must be maintained over the course of two years to receive the lifetime maximum ($1,500). The Essential Plan | Medicaid | Child Health Plus. New Yorkers shopping for a Qualified Health Plan can compare plan options now and be prepared for the 2023 Open Enrollment Period, which begins on November 16, 2022 and runs through January 31, 2023. What do I pay for after I hit my deductible? Create an Account View your Summary of Benefits and Coverage Find a doctor, estimate medical cost and track your deductible and spending View and order your member card Go Paperless! div.card-col-content.card-col-gutters h5, }); Better dental, Flex Cards, transportation, meals, and more.*. What Are the Medicare Income Limits in 2023? To find out how your prescriptions are covered, check our comprehensivelist of covered prescription drugs (also known as the formulary). Unsure which plan you have? } Download Statements & Forms Register & Create Account Helping a member as their personal representative? Frequently Asked Questions Excellus Medicare Advantage plans include Medicare Part D prescription drug coverage. Health Plans for Self-Employed Individuals, International Claim Form in European A4 Paper Size, Reimbursement Account Forms (FSA/HRA/HSA), Away From Home Care Guest Membership Application, Continuing Coverage for Students on Medical Leave Form, Medical Change Form for Direct Purchase Plans, Dental Change Form for Direct Purchase Plans, SimplyBlue Gym Membership Incentive Reimbursement Form. Implants (limited coverage requires preauthorization). Knowing you've got the most trusted coverage during the moments that matter most. vertical-align: unset; Here are some example costs youll see with Excellus Medicare Advantage plans in different coverage areas in 2022: Medicare Advantage (Part C) plans take the place of Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), often referred to as original Medicare. Here are facts to help you decide. Copyright 2023, Excellus BlueCross BlueShield, a nonprofit independent licensee of the Blue Cross Blue Shield Association. $('.panel-grid').addClass('container-block'); Types of service, co-pay amounts and deductible information are located under the Common Benefits section. Learn about the basics of Medicare, the difference between Medicare Advantage and Medicare Supplement, working past 65, and more. .main-content-card { See Join Our Network. You have more freedom to see providers outside of your network, but youll pay a higher copay. .entry-content { Submit a complaint about your Medicare plan atwww.Medicare.govor learn about filing a complaint by contacting the Medicare Ombudsman. Plans Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Tealeaf code added thru script to this page, Health Insurance Plans for Excellus BCBS Member, Stay informed on vaccines, testing coverage and more. Blue Select, College Blue, Dental Blue Options, Federal Employee Program, Pediatric Dental, SimplyBlue Plus Dental, & SmileSaver Search Local Dentists .entry-content img { An HMO-POS is like a blend of an HMO and PPO. NY State of Health will include this information in renewal notices sent to consumers. Invoices will be mailed quarterly from LBS. }); Links marked with an (external site) icon indicate you're leaving ExcellusBCBS.com. National Dental GRID The Dental GRID includes dentists in all 50 states through the networks of participating Blue plans and their aliates. Register & Create an Account Questions? Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Life Eventsinclude:getting pregnant, having a baby, adopting a baby, change in marital status, moving, losing coverage from your employer, or aging off of a parents health plan. These rates are applicable for 4R and 5R Retiree levels. 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! It includes compensation, health care plans, tuition benefits, retirement plans, and so much more. Watch our Medicare Minute Videos to learn more about initial enrollment and working past 65. Taxpayers are not required to include a Form 1095-B when filing their taxes. You can review the prescription drug lists covered by our plans at ExcellusBCBS.com. Consumers can sign up for NY State of Health text alerts to receive important health insurance updates, including when it's time to renew, by texting START to 1-866-988-0327. Enrollment in Excellus BlueCross BlueShield depends on contract renewal. top: 0; -webkit-border-radius: 6px; Helping a friend or family member as they navigate Medicare enrollment or switch plans can be overwhelming. Excellus BlueCross BlueShield is part of The Lifetime Healthcare Companies, a family of companies that now provides health insurance coverage to nearly 1.5 million people across 39 counties of New York state. 1-877-406-4823 (TTY: 711), Open Monday-Friday 8 a.m. 8 p.m.*. border: none !important; $(this).prev( "div" ).find(".card-col-content").html(cur_announcement); Need Help? Dentist. and get answers to the most common questions we hear about Medicare. Attention Providers! and check to see if your prescriptions are covered. Register for secure access to our site as either a Medical or Dental provider. } For questions about health plans and income eligibility, call Excellus BCBS at 1-888-576-6542. Maintaining good oral health is vital to your overall health and wellness. }); Dental Customer Service - for members and dentists 1-800-724-1675 Hours: Monday - Thursday 8:00 am - 5:30 pm Friday 9:00 am - 5:30 pm Mailing address for claims Excellus BCBS PO Box 21146 Eagan, MN 55121 This is not a contract or binding agreement; it is a summary of benefits and services. For example, if you turn 65 on July 4, you can enroll anytime between April 1 and October 31. The Dental Plans allow you the freedom to see any dentist you choose. Each year, we provide thousands of hours worth of in-person and online learning & professional development programs. margin: 20px 0; Or, you may be eligible for other NYS-sponsored plans or subsidies. View your Summary of Benefits and Coverage, Find a doctor, estimate medical cost and track your deductible and spending, Go Paperless! $("section#portlet_com_liferay_announcements_web_portlet_AnnouncementsPortlet div.entries .card-col-field .dropdown-menu .taglib-text-icon").each(function (){ Choose to enroll online, by mail when you order an enrollment kit, or by phone. After you put your group number in just hit search to find providers in your plan. } Find Your Doctor, Hospital or Other Provider Apply Need Help? Star Ratings are released annually and are based on member satisfaction, plan details, and overall performance. 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. Space is limited, so we ask that you register in advance of your desired event. margin: 0 20px; $("section#portlet_com_liferay_announcements_web_portlet_AnnouncementsPortlet div.entries .card-col-field .dropdown-menu a.lfr-icon-item").addClass("dismiss-icon"); However, Excellus doesnt offer standalone Part D plans. If you reach your deductible, you may have a copay for some services and coinsurance for others. Total Rewards is the holistic way we reward our employees. There are currently more than 17,500 employers signed on with the Small Business Marketplace (SBM), the highest level since its inception in 2013. Our two dental plans, the Traditional Plan and Medallion Plan, are both administered by Excellus BlueCross BlueShield and offer you coverage for your dental needs. The Dental Plans allow you the freedom to see any dentist you choose. Instead of a fixed-dollar amount, you pay a percentage of the total bill. Excellus BlueCross BlueShield is an HMO plan and PPO plan with a Medicare contract. To talk to one of our dedicated Insurance Advisors today about your options, call 1-888-576-6542. Select from the choices below to find a dentist in your plan's network: Local Networks Refer to the plan name on your member card. Select plans also offer a $500 flex card to use toward out-of-pocket dental, hearing, or vision expenses. PROSPECTIVE MEMBERS Group or Individual: PPO/EPO Panels Managed Care/Comprehensive/Select plans Discount Plan Healthcare Exchange (ACA): Copyright 2023, Excellus BlueCross BlueShield, a nonprofit independent licensee of the Blue Cross Blue Shield Association. div.card-col-field { We use cookies and other technologies to optimize site functionality, analyze website traffic, and share information with social media, advertising, and analytics partners. top: 15px; In certain counties, Facilitated Enrollers are available by appointment. div.card-col-field { When health care is more accessible and affordable. Some Excellus HMO plans are standard HMOs, but others are HMO Point-of-Service (HMO-POS) plans. Dr. Once you hit your out-of-pocket max, all you need to do is to continue paying your monthly premium. "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. } NY State of Health Announces 2023 Health and Dental Insurance Options, Health & Safety in the Home, Workplace & Outdoors, Clinical Guidelines, Standards & Quality of Care, All Health Care Professionals & Patient Safety, James V. McDonald, M.D., M.P.H., Acting Commissioner, Multisystem Inflammatory Syndrome in Children (MIS-C), Addressing the Opioid Epidemic in New York State, Health Care and Mental Hygiene Worker Bonus Program, Maternal Mortality & Disparate Racial Outcomes, Help Increasing the Text Size in Your Web Browser, Empire Blue Cross HealthPlus and Empire Blue Cross Blue Shield HealthPlus, Excellus (Excellus Blue Cross Blue Shield in Central NY and Univera in Western NY), Health Insurance Plan of Greater New York (EmblemHealth), Highmark (Highmark of Northeastern NY and Highmark of Western NY), Excellus (Excellus Blue Cross Blue Shield in Central NY and Univera in Western NY, Highmark BlueCross BlueShield of Western NY, Empire (Empire Blue Cross and Empire Blue Cross Blue Shield), Excellus (Excellus Blue Cross Blue Shield in Central NY and Univera in Western NY)*, Health Insurance Plan of Greater New York (EmblemHealth)*, Empire HealthChoice Dental BlueCross and Empire Health Choice Dental Blue Cross BlueShield, Excellus Dental and Excellus Univera Dental, Certified Enrollment Assistors can provide consumers with free. All Medicare Advantage Plans include coverage for preventive dental services like cleanings and x-rays. I would like to receive emails from Excellus BCBS, such as Wellness and Health newsletters and more. box-shadow: 0 0 0 1px rgb(0 0 0 / 10%), 0 2px 3px rgb(0 0 0 / 20%); Excellus offers both HMO and PPO plans at a variety of price points, including plans with no premiums in some counties. By checking the box, I agree to receive health tips and information by email from Excellus BlueCross BlueShield. Plan pays 100% of in-network negotiated rates, no deductible, **Covered at 50%, subject to orthodontia lifetime maximum Were looking for talented, skilled, and dedicated professionals to join us as we learn, discover, heal, and create. With a PPO you also wont need a referral to see a specialist, as you would with an HMO. Last medically reviewed on July 15, 2020. We are challenging everything about our health plans and broadening the verydefinition of health coverage to bring you more benefits with lower costs. Complete your enrollment during your Initial Enrollment Period. ($1,500 total to be paid over the course of 2 years). Get care safely from home with telehealth services through your in-network provider or 24/7 telemedicine through MDLIVE. 2023 Healthline Media LLC. We can help you get coverage. Create an online account or download our mobile app today! Choose to enroll online, by mail when you order an enrollment kit, or by phone. If you have a question or need help finding or completing a document, our contact page will point you in the right direction. An HMO is a common type of health insurance plan. The company offers insurance plans throughout the region, including many Medicare Advantage options. New Enhanced Dental Coverage. Links marked with an (external site) icon indicate you're leaving the Medicare portion of ExcellusBCBS.com. Yes! Visit our Resource Centers or get expert advice from our Facilitated Enrollers by phone or in a face to face appointment in certain counties. We encourage New Yorkers to begin previewing their 2023 health plan options and premiums today using the 'Compare Plans and Estimate Cost' tool.". Medicare Advantage Plans cover all Medicare services. There are several resources available to help consumers shop and compare plan options: Enrollment in the Essential Plan, Medicaid and Child Health Plus is open all year. Medicare regulates these plans and makes sure they cover all the same services as original Medicare including: Many plans also offer extra coverage for things original Medicare doesnt cover, like dental, vision, and hearing services. 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. Note: At this time, dental benefits are not available to SEIU retirees or surviving spouses. Consumers in the counties served by these insurers will continue to have a choice of three or more insurers offering dental plans. In some cases, consumers will have to select a new plan when they renew their coverage for 2023. Log in with your username and password to access forms, authorizations, news and more. It includes compensation, health care plans, tuition benefits, retirement plans, and so much more. This helps our employees and managers keep up with skills, expand their knowledge, and work better together. All 12 insurers that offered Qualified Health Plans last year will offer them again in 2023. 4 questions to ask when choosing a health plan. Answer a few questions to get started with your Medicare timeline. Health Insurance Plans for Excellus BCBS Providers. 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. These plans offer services that Medicare doesn't. .entry-content .btn { } Other plans might be available in more places, but the price will vary based on your location. We avoid using tertiary references. display:none !important; Create an Account Check eligibility and benefits for members Review claim status and request claim adjustments View fee schedules, policies, and guidelines Manage practice information, access staff training and complete attestation requirements Not a participating provider? How do I help a loved one find the right Medicare plan? Here are some resources to simplify the process and guide you along the way. See additional information. You may be able to join or switch plans under special circumstances that grant a Special Election Period. 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. Any premium for a Medicare Advantage plan will be in addition to the premium you pay for Part B. You can view the status of your account on the LBS member portal or mobile app. For example, if you turn 65 on July 4, you can enroll anytime between April 1 and October 31. color: black; Start a chat by selecting the blue chat box or request a call with one of our Facilitated Enrollers. View our Medicare Advantage Timeline to learn more. If you're turning 65, you can enroll in Medicare from the period that extends 3 months before to 3 months after the month of your 65th birthday. Well also email you a free guide to help you shop for health insurance. Enrollment in Excellus BlueCross BlueShield depends on contract renewal. To submit a claim electronically, please login and go to Submit Claims page. To chat with a licensed agent, click the blue chat box on the screen. More coverage for restorative and major dental services (i.e. Enrollment for 2022 coverage continues through the end of the year. You have a couple of options to pay your bill: View your account at any time by setting up your online account today with LBS. -moz-border-radius: 6px; To talk to one of our dedicated Insurance Advisors today about your options, call 1-888-576-6542. Dental Providers: If you need assistance navigating our new experience (registration help, managing user access, etc. See our Privacy Policy for how we use information. Depending on your county, you can choose from PPOs, HMOs, or HMO-POS plans. Beginning January 1, 2022, The University had adopted Dental Grid+ through Excellus. padding: 0 !important; Terms of Use | Web Privacy Policy | Accessibility Statement. } For example: If your coinsurance on a $100 bill is 15%, you pay $15 and we pay the rest. The 12 insurers offering the Essential Plan in 2022 are: Eligible small employers can lower the cost of offering employee coverage with the federal small employer tax credit when purchasing Small Business Marketplace-certified plans offered through NY State of Health.
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