GM adds cost-sharing for DME/P&O

GM will soon begin applying cost-sharing to DME/P&O claims for the hourly membership in group 83200. The change begins Jan. 1, 2013, for DME/P&O claims purchased from a DME supplier and processed through Northwood National Providers Network.

BCBSM will continue to administer DME claims for supplies provided in a doctor’s office or hospital with no changes in cost-sharing amounts.

GM “entry level” and “flex” members’ out-of-pocket amounts are:

In-network deductible: Single, $300; family, $600
Out-of-network deductible: Single, $1,200; family, $2,100
Coinsurance: In-network, 10 percent; out-of-network, 35 percent
In-network out-of-pocket maximum (per calendar year): Single, $1,000; family, $2,000
Out-of-network, out-of-pocket maximum: Single, no limit; family, no limit

The GM Traditional plan has no a deductible or coinsurance for in-network services; however, the out-of-network cost-sharing is:

Deductible: None
Coinsurance: 10 percent
Out-of-pocket maximum: Single, $250; family, $500