Page 8 - Touching All the Bases- Power point 2023 Umpires_Neat

First: Health & Wellness

Medical – Highmark Blue Cross Blue Shield

Despite the rising cost of medical services, Baseball provides its employees with broad-based medical plan
coverage. The plan is a preferred provider organization (PPO) administered by Highmark Blue Cross Blue
Shield. Through Highmark, you have access to a national network of doctors and hospitals, and the freedom of
choice to select your provider from the national PPO network or from a provider outside of the PPO network.
There is no requirement to select a primary care physician to coordinate your care.

If you use a network provider, you receive the highest level of coverage—you pay a copay for certain services,
such as office and emergency room visits and prescription drugs. There are no deductibles, no claim forms to
submit, and no additional physician balances to pay.

If you seek treatment from a non-network provider, the coverage level for eligible services is 80% after you
meet the plan deductible. Reimbursement for out-of-network plan expenses is based on reasonable and
customary charge limits; you pay any charges considered to be above these limits. (Your out-of-pocket
expenses, however, are capped each year.) Also, you may have to file claims with Highmark for non-network
care. Refer to the chart on the next page for highlights of your medical plan coverage.

In addition to the benefits described below, your PPO plan includes:
• A dedicated Customer Service Unit at 1-800-701-2324
• Blues On Call at 1-888-BLUE-428 (providing a health coach 24 hours a day, 7 days a week, to discuss
confidential health topics)
• My BlueLink website at www.highmarkbcbs.com (offering services related to your healthcare coverage
and tools for managing your own well-being)
• Smoking cessation program

KEEP IN MIND!
Network providers: All doctors must be in the network in order for you to receive in-network benefits.
If you are being referred to another provider, make sure your doctor refers you to a network provider. If
the provider is not in the PPO network, you will receive the out-of-network level of benefits.

To find a participating provider, pharmacy or to learn more about the Highmark drug formulary, log on
to www.highmarkbcbs.com and click on Find a Provider, Locate a Pharmacy or Highmark Formulary.

Hospital admissions: If you need to be admitted to the hospital, you must call the number on your ID
card for pre-approval. If you do not contact Highmark in advance of your admission, or within 48 hours
of an emergency admission, you may be subject to a $1,000 penalty.

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