Medicare AdvantageNovember 1, 2024
CEBP moves to Medicare Advantage plan for Anthem
Effective January 1, 2025, Conservation Employees’ Benefits Plan Trust Fund (CEBP) in Missouri will offer a Medicare Preferred Provider Organization (PPO) plan through Anthem.
Anthem will provide medical benefits for CEBP retirees through the 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.
CEBP members’ copay or coinsurance percentage will be the same whether their provider is in-network or out-of-network. Locally or nationwide, doctors or hospitals, member share of cost (SOC) does not change.
Non-contracted providers may continue treating CEBP members and will be reimbursed 100% of Medicare’s allowed amount for covered services.
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 ZMX.
Detailed prior authorization requirements are also available to contracted providers by accessing the Provider Self-Service Tool on the Availity website at Availity.com.
Providers will follow their normal claim filing procedures for CEBP member claims.
Providers may call Provider Services at 833-848-8730 for eligibility, prior authorization requirements, and any questions about the CEBP member benefits or coverage.
In Missouri (excluding 30 counties in the Kansas City area): Anthem Blue Cross and Blue Shield is the trade name of RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
MOBCBS-CR-069326-24
PUBLICATIONS: November 2024 Provider Newsletter
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