Page 6 - 2022 Benefit Guide Bronx

Medical Plan Benefits

Take Advantage of Preventative Care
Manage your health plan online at
bcbsm.com; then download the APP Covered 100% In Network
• Annual Health Exam (over age 4) – one per calendar year
• Well Child Exams: per calendar year
- 8 visits, birth through 12 months
Why have an account? - 6 visits, 13 months through 35 months
• Check your coverage, deductible and claims information. - 2 visits, 36 months through 47 months
• Find A Doctor or Hospital and compare providers. • Screenings: one per calendar year each for mammogram, pap
smear, PSA and endoscopic
• Compare quality and costs for hundreds of services – from
MRI’s to surgeries and doctor visits. • Immunizations per ACA and age requirements such as: flu
shots; shingles; tetanus; HPV; required vaccines birth – age 7.
• Set up text alerts Covered through a network pharmacy or physicians office.
• Prescriptions such as: contraceptives; generic statins (age 40-
• Most features are also available on your mobile device. 75); some generic aspirin; smoking cessation >age 18 limited
• BCBSM APP: obtain a virtual ID Card. to 180 days

Choose the Right Place for Care Manage your prescriptions
Your health is important. Knowing what your options are to
get the care you need, when you need it, could save you time
and money. Avoid more expensive options such as urgent
care and emergency room. Your prescription (Rx) benefits for the BCBSM plans is
o 24 Hour Nurse Line to ask general medical questions at provided by Express Scripts. Use your separate Rx ID Card
1.800.775.2582 (no charge) for prescription benefits.
o 24/7 online healthcare through BCBSM. Video chat with a • Check out the list of drugs covered at 100% as allowed by
physician (when your primary physician is not available) ACA. Includes many generics for health conditions such
for minor illness from your phone /computer. as asthma, diabetes, cholesterol lowering and high blood
Fee: $10 PPO or $49 CDHP pressure.
Mobile: download BCBSM Online Visits App Prescription Benefits:
Web: bcbsmonlinevisits.com • Formulary and Price Comparison: log into your account at
Phone: 1.844.606.1608 www.express-scripts.com to review the prescription
formulary or compare prices to find cheaper prescriptions.
o Your Physician for routine, regular care and virtual visits.
Fee: $25 or $35 copay for PPO; network price for CDHP • Maintenance Medication: Save money by ordering
maintenance medications as a 90-day supply, available at
most retail pharmacies or convenient home delivery.
Blue Cross Health & Wellness Prescriptions must be written for a 90-day supply.
Your gateway to resources to help you get healthy, stay • Specialty Medications: Provided by Accredo. Log into
healthy or manage an illness. Log in and click on Health & express-scripts or call 800.803.2523 for services.
Wellness
• Check out Blue365 for health/wellness discounts
After your effective date of coverage
• Digital Health Assistant – six online coaching programs For more information or to locate a provider or pharmacy,
help you make small changes to improve your health create your account online at.
• WebMD Health Topics – search for a variety of health Website: www.bcbsm.com www. express-scripts.com
topics, procedures and surgeries Have a question call the Client Service Center:
BCBSM: 800-752-1455 Express-Scripts: 844-826-5572
Refer to the Summary of Benefit Coverage and Benefits at a
Glance for additional coverage and limitations.

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