Changes to emergency room benefits coming to Michigan Conference of Teamsters Welfare Fund group

Effective immediately, the Michigan Conference of Teamsters Welfare Fund’s medical director is reviewing emergency room records for claims that exceed three visits in a 12-month period for members and their covered dependents to determine if the condition treated was an emergency. Members are responsible for obtaining and providing the medical record information for review.

Conditions that may require emergency care are limited to sudden and unexpected medical problems that, if not immediately treated, may result in death or serious bodily harm. The medical director will determine if the claim is covered under the group’s plan, and the decision cannot be appealed to Blue Cross Blue Shield of Michigan.

This benefit change — which Michigan Conference of Teamsters Welfare Fund members and their covered dependents have been notified about — was made to help ensure that members and their dependents use their emergency room benefit appropriately.

If members aren’t experiencing an emergency, but still need immediate medical care, they should seek treatment from a local urgent care center if their doctor isn’t available.

For more information about this benefit change, please contact the Michigan Conference of Teamsters Welfare Fund’s Member Services at 313-964-2400.