Here are some highlights of changes to 2018 products, health care options

We’ve received some questions from health care providers about Blue Cross Blue Shield of Michigan’s 2018 product lineup and wanted to provide some highlights and resources for additional information.

Here are a few highlights of changes to 2018 group products and other health care options:

Blue Cross^® Physician Choice PPO
Personal Choice PPO has changed its name to Physician Choice PPO. The product continues to offer a competitive price point for employers with more choices for access and cost sharing for employees. On Oct. 1, we expanded the product to the entire Lower Peninsula.

Physician Choice PPO leverages Blue Cross’ innovative Organized Systems of Care program. OSCs are communities of doctors and hospitals within the Blue Cross PPO network that help provide customized, coordinated care that’s right for each patient. Features include:

• Multiple deductible plan options
• Access to multiple OSCs throughout Michigan’s with more than 4,000 primary care doctors, 11,000 specialists and 100 hospitals
• Access to the entire Blue Cross PPO network as well as out-of-network doctors and hospitals
• Levels of cost share for members based on the choices they make — costs are lowest with a primary care doctor in a Level 1 OSC
• Prescription drug coverage

Smart choices for medical care
When it’s not a true emergency, medical care at a local hospital emergency room can be time-consuming and expensive. That’s why Blue Cross and Blue Care Network offer other health care options that are smart, convenient and low-cost in comparison with emergency room treatment, including:

• Primary care doctor
• 24-Hour Nurse Line
• Blue Cross Online Visits^SM
• Retail health clinics
• Urgent care centers

 Hearing program
For Blue Cross and BCN employer groups with more than 100 full-time equivalent employees, we’ve created three new riders that will offer:

• A hearing exam only
• Frequency at 24 months for a hearing exam plus hearing aid coverage with a dollar maximum allowance of $3,000 for a monaural hearing aid or $6,000 for a binaural hearing aid
• Frequency at 36 months for a hearing exam plus hearing aid coverage with a dollar maximum allowance of $3,000 for monaural hearing aid or $6,000 for binaural hearing aid

 Medical specialty drug coverage
In 2018, the Blue Cross’ medical specialty drug program will expand its prior authorization process to require additional approval to pay for infusion services for select drugs in a hospital outpatient setting. Preferred locations, which are already a Blue Cross benefit, are billed as professional settings, rather than facility settings, and include home infusion, doctors’ offices and infusion centers.

For more information
As always, be sure to check eligibility and benefits for your patients on web-DENIS. For more information on our group products, click here.

For information on our individual products for 2018, see this article, also in this issue.