Effective March 1, 2019, Anthem Blue Cross and Blue Shield (Anthem) began offering an Anthem Medicare Preferred (PPO) plan for the Ozarks Schools Benefits Association, Missouri retirees through Anthem’s Local Preferred Provider Organization (LPPO) product. The plan includes the National Access Plus benefit, which allows members to receive services from any provider as long as the provider is eligible to receive payments from Medicare.

 

Non-contracted providers may continue treating Ozarks Schools Benefits Association members and will be reimbursed 100% of Medicare’s allowed amount for covered services, less any member cost share.

 

Ozarks Schools Benefits Association members’ copay or coinsurance percentage will be the same. For all services provided locally or nationwide by doctors or hospitals for in- or out-of-network treatment, the member’s cost share does not change.

 

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

 

The prefix on the Medicare Advantage ID cards is ZMX.

 

Call Provider Services at 1-833-848-8730 for eligibility, prior authorization requirements and any questions about the Ozarks Schools Benefits Association member benefits or coverage.

 

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

 

Providers will follow their normal claim filing procedures for Ozarks Schools Benefits Association member claims.

 



Featured In:
April 2019 Anthem Provider Newsletter - Missouri