MIChild medical, pharmacy and vision coverage to transition into MIChild plans operating as HMOs; Blue Dental^SM MIChild members to transition to other dental plans

MIChild enrollees currently covered by Blue Cross Blue Shield of Michigan will transition to MIChild-approved HMO health plans starting on Oct. 1, 2013. Most of these plans also offer Medicaid services through their HMO products. MIChild will remain a separate program from Medicaid with its own enrollment criteria and provider reimbursement. It will have the same MIChild benefit package currently available to members. The new model will streamline and coordinate administration and oversight of the MIChild and Medicaid government programs.

Additionally, all current MIChild members with Blue Dental coverage will be transitioned to other MIChild dental carriers, effective Oct. 1, 2013.

The Michigan Department of Community Health has posted letters to medical, vision, pharmacy and dental care providers* on their website to make you aware of the transition. The letters have also been mailed.

How this affects Blue Cross’ involvement in MIChild medical, pharmacy and vision coverage

Blue Cross’ current MIChild plan offers PPO coverage rather than HMO coverage. Blue Cross PPO MIChild members will be transitioned into MIChild-approved HMO plans in phases.

The Blues remain committed to the MIChild population, and we are working with MDCH and other health plans to ensure a smooth transition for members over the next year. We will continue to provide PPO coverage to MIChild members until it’s time for them to choose a MIChild-approved HMO plan. And in the future, our Medicaid HMO subsidiary, Blue Cross Complete, is planning to participate as a MIChild medical, pharmacy and vision coverage provider.

Here are the stages of MIChild member transition for medical, pharmacy and vision coverage:

• New MIChild enrollees (medical, pharmacy and vision) — New MIChild members in 34 counties (see list) will need to select a plan other than BCBSM after July 24. Their enrollment materials will no longer list BCBSM.
• Current BCBSM MIChild enrollees (medical, pharmacy and vision) — MIChild members who currently have Blue Cross coverage will transition to new MIChild HMO plans in stages.
  • The first group, comprising enrollees from 34 counties (see list below), will be transitioned to a new plan for Oct. 1, 2013. They will be notified by letter from MIChild scheduled for mailing on Aug. 28.
  • Enrollees who are renewing Sept. 1 will receive a separate renewal communication that does not list BCBSM.
• Other MIChild members outside these 34 counties who currently have Blue Cross coverage will be transitioned, county by county. MDCH will inform us in the future of this transition schedule. These enrollees will receive a MIChild letter when their county is transitioned, asking them to select a new plan.

The 34 counties that are part of the first transition of medical, pharmacy and vision coverage will involve all counties in the Upper Peninsula and some counties in the Lower Peninsula (listed below):

MDCH may add other counties to this first transition.

How this affects Blue Cross’ involvement in MIChild dental coverage

All current MIChild members with Blue Dental coverage will be transitioned to other MIChild dental carriers, effective Oct. 1, 2013. We are working with MDCH to ensure a smooth transition for members.

Here are the stages of MIChild member transition for dental coverage:

• All Blue Dental^SM MIChild members will transition to other dental carriers. This change will occur on the same date for all members — Oct. 1, 2013. All enrollees will need to pick a new carrier before that date. Blue Dental enrollees will receive a letter from MIChild scheduled for mailing on Aug. 28.
• MIChild Blue Dental enrollees who renew on Sept. 1 will receive a separate renewal communication that does not list Blue Dental.
• New MIChild dental enrollees will need to pick a carrier other than Blue Dental after July 24. Their enrollment materials will no longer list Blue Dental.

Participating with other MIChild insurers
If you want to offer medical, pharmacy, vision or dental care to MIChild members when they no longer have Blue Cross PPO or Blue Dental coverage, you must participate with a MIChild-approved HMO plan or dental carrier.

For the most up-to-date information on which plans are approved to provide MIChild coverage in each county, you can:

• Visit michigan.gov/michild*.
  • Click on MI Child Health Plan Service Contacts and Service Areas Listing under Info for MIChild Providers.
• You can call also contact MIChild’s Medical Services Administration Provider Support line at 1-800-292-2550 or email ProviderSupport@michigan.gov for this information or with any questions you may have.

Helpful documents
Log in to web-DENIS to see the letters sent by MDCH to providers about the changes to the MIChild program’s medical, pharmacy, vision and dental coverage. You can also find answers to questions you may have as a Blue Cross PPO or Blue Dental provider on FAQs that we will update regularly with information as it becomes available. To find these documents:

• Go to web-DENIS.
• Click on BCBSM Provider Publications and Resources.
• Click on Newsletters and Resources.
• Click on MIChild to see the documents:
  • MIChild letter from Michigan Department of Community Health
  • MIChild Provider FAQ

Or see the latest issue of Dental Care News if you’re a Blue Dental provider.

*Blue Cross Blue Shield of Michigan does not control this website or endorse its general content.