Effective March 1, 2019, Laborers Health and Welfare Trust Fund for Northern California will offer an Anthem Blue Cross Medicare preferred PPO plan. Retirees with Medicare Parts A and B are eligible to enroll in the Medicare preferred PPO plan. The plan includes the National Access Plus benefit, which allows retirees to receive services from any provider, as long as the provider is eligible to receive payments from Medicare.

 

Non-contracted providers may continue treating Laborers Health and Welfare Trust Fund for Northern California members and will be reimbursed 100% of Medicare’s allowed amount for covered services, less any member cost share.

 

In addition, Laborers Health and Welfare Trust Fund for Northern California retirees pay the same cost share for both in-network and out-of-network services. Locally or nationwide, doctors or hospitals, in- or out-of-network — the member’s cost share doesn’t change.

The Medicare Advantage plan offers the same hospital and medical benefits that Medicare covers, and also covers additional benefits that Medicare does not, such as an annual routine physical exam, hearing, LiveHealth Online and SilverSneakers®.

 

The prefix on Laborers Health and Welfare Trust Fund for Northern California member ID cards will be MBL. The cards will also show the Laborers Health and Welfare Trust Fund for Northern California name and National Access Plus icon.

 

Providers may submit claims electronically using the electronic payer ID for the Blue Cross Blue Shield plan in their state or submit a UB-04 or CMS-1500 form to the Blue Cross Blue Shield plan in their state. Claims should not be filed with Original Medicare. Contracted and noncontracted providers may call the provider services number on the back of the member ID card for benefit eligibility, prior authorization (PA) requirements and any questions about Laborers Health and Welfare Trust Fund for Northern California member benefits or coverage.

 

Detailed PA requirements also are available to contracted providers by accessing the Provider Self-Service Tool at https://www.availity.com.



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March 2019 Anthem Blue Cross Provider Newsletter - California