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Blue Cross Blue Shield of Louisiana

 
March 6, 2020

 

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UPDATES

 

 

 

Blue Cross and Blue Shield of Louisiana is closely monitoring the spread of the coronavirus (COVID-19) and how it could impact our members, employees and the communities that we serve. Just as we prepare for weather situations such as hurricanes and floods, we have contingency plans in place to ensure our members have access to the care and medications they need.  We will follow CDC, federal and state recommendations regarding the coronavirus, and will:

  • Waive Prior Authorizations for Diagnostic Tests and for Covered Services that are Medically Necessary and Consistent with CDC Guidance if diagnosed with COVID-19. Blue Cross will make members of our in-house clinical team of doctors, nurses, pharmacists and others available to address providers’ or members’ inquiries related to medical services. This will ensure we provide timely responses related to COVID-19.
     
  • Cover the Full Cost of Medically Necessary Diagnostic Tests that are Consistent with CDC Guidance Related to the COVID-19. Blue Cross will cover, with no cost share to the member, the appropriate medically necessary diagnostic testing for COVID-19, where it is not covered as part of the Public Health Service response, and ensure patient testing and any subsequent needed care are done in close coordination with federal, state and public health authorities.
     
  • Increase Access to Prescription Medications by waiving early medication refill limits on 30-day prescription maintenance medications (consistent with member’s benefit plan) and/or encouraging members to use 90-day mail order benefit. Blue Cross will also ensure formulary flexibility if there are shortages or access issues.
     
  • Encourage Telehealth Use for Remote Care. Blue Cross customers and dependents covered on their plans can use BlueCare, our service for 24/7 online visits with U.S. trained, board-certified doctors. BlueCare works on any device that has internet and a camera, like a smartphone, laptop, tablet or computer. BlueCare is available in all 50 states. This is a good option for people who feel too ill to leave the house or want to consult with a healthcare provider before coming into a clinic for treatment.

    To create an account, members can go to www.BlueCareLA.com or get the “BlueCare” (one word) app for Android and Apple devices. Once members have created an account, they can simply log in when they need to have a telehealth visit. 

We encourage our members to seek information about COVID-19 from trusted health sources. For more information, members can visit the CDC’s website, www.cdc.gov, or the Louisiana Department of Health website, www.ldh.la.gov.
 

 

 

 

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Please read carefully. Below is a list of policy changes that will become effective Jan. 1, 2020 for new and existing group contracts. Please become familiar with these changes and keep them with your policy.

 

 

CHANGES APPLICABLE TO BOTH

 

 

GRANDFATIIERI':D AND NON-GRANDF'ATHERED Ml•:ntCAL PLANS:

 

 

 

 

 

 

 

 

 

 

 

Changes to Telehealth Benefit

 

Current

Telehealth benefits are available for remote diagnosis and treatment services when you and your Provider are not physically in the same location.

 

2020

Effective I /112020, the telehealth benefit is being expanded to include the following services:

    • Asynchronous Telehealth for remote evaluation of pre­ recorded information,
    • Virtual Chronic Care Management (CCM),
    • Additional Preventative Services including, but not limited to, alcohol counseling, depression screening, and tobacco counseling services,
    • Prolonged Preventative Services.

 

 

 

CHANGES APPLICABLE TO

 

 

NO -Cl A:\DFATIIERED MEDICAL PLANS:

 

 

 

 

 

 

 

 

 

 

 

Additions and Changes to Preventive Services Governed by USPSTF

(U.S. Preventive Services Task

Force)

 

The ACA requires preventive and wellness service coverage per U.S. Preventive Services Task Force (USPSTF) recommendation levels 'A' and 'B'. These preventive and wellness services will be covered at no cost to you when rendered by a Network provider. The services listed below will

be added to policies for 2020. Additional services may be added as required by law and may include enhancements to existing services.

 

 

  • Reduce Unhealthy Alcohol Use- available at no cost if received from a Network Provider in primary care settings for adults 18 years or older, including pregnant women, to provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce unhealthy alcohol use. This recommendation replaces the 2013 USPSTF recommendation statement on screening and behavioral counseling interventions for alcohol misuse. The term "alcohol misuse," used in the 2013 recommendation, has been replaced by the term "unhealthy alcohol use."

 

 

 

Blue Cross Blue Shield of Louisiana

 
November 13, 2018

 

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UPDATES

 

 

 

Robocall Scams: Information and Update

Blue Cross and Blue Shield of Louisiana has received reports that individuals are receiving robocalls across the country that falsely claim to be made by “Blue Cross and Blue Shield.” These calls may try to sell insurance products or collect personal information from the people they call. Blue Cross and Blue Shield of Louisiana is NOT making these calls.

If your employees get one of these recorded calls claiming to be from Blue Cross and Blue Shield, please share these tips and information:

  • Hang up right away if you get a recorded call from someone you did not ask to call you. The call is likely fraudulent or malicious.
  • Do not respond to prompts such as “press 1 to speak to the operator or get your name taken off the list.” If you respond, you’ll probably get more calls.
  • Do not give personal or financial information.
  • Block the numbers of robocallers from your cell phone.
  • Watch out for “spoofing” technology that makes the same calls appear to come from different numbers.
  • If you are not sure you have Blue Cross on the line, you can hang up and call Customer Service at the number on your ID card to see if you should be receiving calls about care and coverage with us.

Please know that we are committed to keeping our members' private information safe. We have many measures in place to protect it, such as following federal privacy rules and others.
 
You can read more about how we protect your privacy at bcbsla.com/privacy. As always, we appreciate your business!
 

 

 

 

 

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Copyright © 2018 Blue Cross and Blue Shield of Louisiana, All rights reserved.


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AFFINITY HEALTH GROUP LEAVING BLUE CROSS BLUE SHIELD

Affinity Health Group has given Blue Cross Blue Shield notice that it will leave its networks effective January 1, 2017.  This means that beginning on this date students will no longer be able to visit the doctors and other providers who work for Affinity Health Group without having to pay costly out-of-network rates. 

 

STUDENT HEALTH INSURANCE INFORMATION AND PROCEDURE

LSUHSC-New Orleans offers students the option of purchasing student health insurance through Blue Cross Blue Shield of Louisiana (BCBSLA). During registration, students must either purchase insurance coverage from BCBSLA or must be prepared to show evidence of coverage by another company, in which case the requirement to purchase may be waived. Students who receive medical treatment or who are referred to outside hospitals or clinics will be responsible for their bills. Students will be expected to pay the charges and then file a claim with their insurance carrier.

The premiums for the new plan year are included in the 2019 - 2020 LSUHSC Student Health Insurance brochure. We will be collecting these premiums semi-annually or for six months at a time. The annual plan year runs from July 1, 2019 to June 30, 2020. There are no provisions in the plan to provide COBRA coverage to students who graduate or withdraw from school.

Example: Mary receives her M.D. degree on May 15th, her student health plan coverage ends on June 30th. She begins her new job on July 1 and her insurance through her new employer begins on August 1. Mary will have to make arrangements to obtain coverage for the month of July until her new plan is effective.

BCBSLA does not offer COBRA coverage because it is only required by law for employee health insurance plans. If you plan on graduating in May 2020 and have paid for the health insurance plan, you will have coverage until June 30, 2020.

If you still have questions after reviewing the brochure and the information on this web site, please email shi@lsuhsc.edu.

 

Procedures for Students to Obtain Coverage for Themselves

  1. Students obtain health insurance policy or produce evidence of coverage that supports a waiver from purchasing health insurance policy during the registration process at the Bursar's Office located on the first floor of the Resource Center Building (433 Bolivar Street). Students with waivers are assessed a premium for needle stick benefits only.
     
  2. For continuing students, we are assuming they will want to maintain the same coverage they had at the end of the 2018-19 academic year. If not, please see voluntary changes below.
     
  3. The LSUHSC Bursar's Office will collect premiums due to BCBSLA when students opt for coverage or process refunds due to the student when coverage is being dropped. Please see voluntary and involuntary changes below.
     
  4. Open enrollment periods: Fall 2019 - Students are permitted to enroll for insurance effective July 1, 2019 for a period of 62 days ending August 31, 2019. Spring 2020 - Students are permitted to enroll for insurance effective January 1, 2020 for a period of 31 days ending January 31, 2020. Summer 2020 - Students are permitted to enroll for insurance effective May 1, 2020 for a period of 31 days ending May 31, 2020.
     
  5. Students may be asked to provide BCBSLA with proof of prior coverage from their previous insurance carrier.

 

Procedures for Students to Make Voluntary Changes in Coverage

  1. Students will go to the Bursar's Office to process voluntary changes within the deadlines shown above under open enrollment periods.
     
  2. LSUHSC Bursar's Office will collect premiums due to BCBSLA when students opt for coverage or process refunds due to the student when coverage is being dropped.
     
  3. Students may be asked to provide BCBSLA with proof of prior coverage from their previous insurance carrier.

 

Procedures for Students to Make Involuntary Changes in Coverage Due to Qualifying Events

  1. A qualifying event includes involuntary loss of coverage under another health insurance plan, marriage or birth or adoption of a child.
     
  2. Students with qualifying events who wish to enroll in the student health insurance plan and contact the Bursar's Office during the first through fifteenth day of each month will be enrolled effective the first day of that month and charged a prorated premium beginning with that date.
     
  3. Students with qualifying events who wish to enroll in the student health insurance plan and contact the Bursar's Office during the sixteenth through the last day of each month will be enrolled effective the first day of the following month and charged a prorated premium beginning with that date.
     
  4. Students may be asked to provide BCBSLA with proof of prior coverage from their previous insurance carrier.

 

Procedures for Residents, Fellows and House Officers to Obtain Student Health Insurance

To enroll in coverage for the medical or needle stick plans, please contact our local partner Gallagher Benefit Services at lsu.hsc.gbs@ajg.com or 225-906-1280 .

 

Procedures for Students to Obtain Coverage for Dependents

Premium costs for your eligible dependents (spouse and children) to enroll in the medical plan varies according to each dependent’s age. For more information and/or to enroll your eligible dependents, please contact our local partner Gallagher Benefit Services at lsu.hsc.gbs@ajg.com or 225-906-1280 .

Please note that you must enroll your dependents within 30 days of the effective date of coverage for your specific program, and you must pay the total premium due through the end of the current academic term upon enrollment.

Please refer to page 3 of the Student Health Insurance Brochure for a list of programs and effective dates. If enrollment doesn’t occur within those 30 days following the effective dates, you will be only allowed to enroll your dependents within 31 days of an involuntary loss of coverage or a qualifying life event.

 

Student Dental And Vision Insurance Information And Enrollnment

 LSUHSC-New Orleans offers students and their dependents the option to purchase dental and vision coverage through AlwaysCare. Student Only, Student + One, and Student + Family options are available.

The AlwaysCare dental plan includes coverage for preventive, basic, and major services at an affordable cost.   All preventive services are covered 100% with no waiting period, and a portion of your unused benefits may carry over from year to year.  For more detailed plan information, click HERE

The AlwaysCare vision plan includes coverage for an eye exam and either contact lenses or eyeglass frames and lenses every 12 months.  With this plan, you will have access to a national network of independent eye care professionals and large optical retail chains including Walmart, Pearle Vision, Target, Sears, and Visionworks. For more detailed plan information, click HERE

To enroll, visit HERE

 

Needle Stick Coverage

  1. Coverage is provided for eligible students for testing and prophylactic treatment of blood-borne diseases following at-risk contact with blood or other body fluids from human or animal sources. This contact may include but is not limited to needle sticks. This benefit is not subject to any co-payment or annual deductible requirement.
     
  2. The stick fee coverage has been upgraded to include a 3 day supply of prophylaxis drugs to be prescribed when a student has experienced a needle stick. The needle stick policy identification card that students receive in the mail includes information necessary to process pharmacy claims in the event of a needle stick.   
     
  3. Students who have Medicaid as their primary insurance must present both their needle stick card and their Medicare card to the pharmacy for ALL prescriptions.
     
  4. Services must be received at any BCBSLA network provider including but not limited to:
    • The LSU Student Health Clinic
    • Children's Hospital in New Orleans
    • Our Lady of the Lake
    • Baton Rouge General Hospital
    • Ochsner Hospital
    • Ochsner Baptist
    • Baton Rouge General Occupational Health
    • LabCorp
    • Our Lady of Lourdes Rapides Medical Center in Lafayette
    • Medical Center of Louisiana at New Orleans
    • University Medical Center in Lafayette
    • Walter Moss Medical Center
    • Leonard Chabert Medical Center
    • Lallie Kemp Medical Center
    • Our Lady of Angels Hospital
    • Touro Infirmary
    • East Jefferson General Hospital
    • West Jefferson Medical Center
       
  5. LSUHSC Student Health Clinic information is available at http://www.lsuhsc.edu/orgs/studenthealth/ .
     
  6. Students who are charged the needle stick only fee have provided proof of having their own insurance policy and should be familiar with the benefits offered by their own insurance plan for needle sticks.

 

 Student Health Insurance Brochure

Here is a link to the LSUHSC Student Health Insurance Brochure for 2018-2019:

/orgs/studenthealth/insurance/docs/LSU_Health_Brochure.pdf