Northern California Cement Masons, California moves to Medicare Advantage plan

Effective January 1, 2022, Northern California Cement Masons in California will offer an Anthem Blue Cross (Anthem) Medicare Preferred (PPO) plan. Anthem will provide medical benefits for Northern California Cement Masons retirees through the Preferred Provider Organization (PPO) product, which includes the National Access Plus benefit. The PPO plan allows members to receive services from any provider, as long as the provider is eligible to receive payments from Medicare.

Northern California Cement Masons members’ copay or coinsurance percentage will be the same whether their provider is in- or out-of-network. Locally or nationwide, doctors or hospitals, member share-of-cost (SOC) doesn’t change.

 

Noncontracted providers may continue treating Northern California Cement Masons members and will be reimbursed 100% of Medicare’s allowed amount for covered services, less any member SOC.

                                                                

The Medicare Advantage plan offers the same hospital and medical benefits that Medicare covers, while covering additional benefits that Medicare does not, such as LiveHealth Online* and SilverSneakers. *

 

The prefix on the Medicare Advantage ID cards is MBL.

 

Prior authorization requirements are also available to contracted providers by accessing the Provider Self-Service Tool on the Availity* Portal at https://www.availity.com.

 

Providers will follow their normal claim filing procedures for Northern California Cement Masons member claims.

 

Providers may call the number on the back of the member’s ID card for eligibility, prior authorization requirements, and any questions about the Northern California Cement Masons member benefits or coverage.

 

* Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross. Tivity Health, Inc. is an independent company providing the SilverSneakers fitness program on behalf of Anthem Blue Cross. LiveHealth Online is the trade name of Health Management Corporation, an independent company, providing telehealth services on behalf of Anthem Blue Cross.
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