Effective January 1, 2019, Colorado PERA will offer two Anthem Medicare Preferred (PPO) plans. These two Anthem Medicare Preferred (PPO) plans will replace the current Anthem Medicare Supplement Plans, Rocky Mountain Health Plans Medicare HMO and UnitedHealthcare Medicare HMO plans. The plans include the National Access Plus benefit. With the National Access Plus benefit, retirees are free to receive services from any in-network provider, as well as any out-of-network provider who is eligible to receive payments from Medicare. Colorado PERA retirees will pay the same cost share for both in-network and out-of-network services. The MA plan offers the same hospital and medical benefits that Medicare covers and also covers additional benefits that Medicare does not, such as hearing, vision, chiropractic care, LiveHealth Online and SilverSneakers®.

 

The prefix on Colorado PERA cards will be CBH. The cards will also show the Colorado PERA logo and National Access Plus icon.

 

Providers can 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 non-contracted providers may call Provider Services at 1-833-244-3888 for benefit eligibility, prior authorization requirements and any questions about Colorado PERA member benefits or coverage.

 

Detailed prior authorization requirements also are available to contracted providers by accessing the Provider Self-Service Tool at Availity.com.

 

PROVIDERS: If you have an approved prior authorization with a date of service that is October 1, 2018 or later, please fax the approval to Anthem at 866-959-1537. We will enter the approval in our system and no other action is needed on your part.

For additional information, also reference previous publication New 2019 Health Care Plan information for all Colorado PERA Retirees - CO


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Featured In:
December 2018 Anthem Provider Newsletter - CO