Hospital Choice Cost Sharing Launch Kit - Initial Letter
Dear Employees,
We are writing to let you know about a change in our health coverage for 2011 that helps you better manage your out-of-pocket medical costs.
This new plan will now include Hospital Choice Cost Sharing benefits. It has two levels—Lower Cost Share and Higher Cost Share. Control your share of the medical costs for certain services based on the hospital you choose for care.
We made the decision to offer you these benefits because it‘s a step toward keeping quality health care affordable. It rewards you for choosing health care facilities that deliver high-quality care and control costs.
The result is lower-cost coverage for you, your family, and all your coworkers. It’s part of a growing movement in the health care field to reward members for making thoughtful decisions about where to get care.
These two-level benefits apply to the following services:
· Inpatient care
· Outpatient day surgery
· Outpatient diagnostic high-tech radiology
· Outpatient diagnostic lab tests
· Outpatient diagnostic X-rays, and other imaging tests
· Outpatient short-term rehabilitation therapy
Emergency care is NOT included in the two levels. Because you don’t have a choice in an emergency, you’ll always pay the lower cost share when you get emergency care—even if you are admitted to the hospital through the emergency room.
To help make the transition to our new plan easier, Blue Cross Blue Shield of Massachusetts has setup a dedicated Member Service team that you can contact at 1-888-636-4808 and website at www.bluecrossma.com/hospitalchoice. Use these resources if you have any questions or need help.
You’ll be hearing more about the new plans during the upcoming Open Enrollment season. We urge you to take the time to understand this new benefit. It’s important that you review the benefits and your providers before you get care to avoid any unexpected costs.
Sincerely,
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This health plan option includes a tiered network feature called Hospital Choice Cost Sharing. As a member in this plan, you will pay different levels of cost share* (such as copayments and/or coinsurance) for certain services depending on the network* general hospital you choose to furnish those covered services. For most network* general hospitals, you will pay the lowest cost sharing level*. However, if you receive certain covered services from some network* general hospitals, you pay the highest cost sharing level*. A network* general hospital's cost sharing level may change from time to time. Overall changes to add another network* general hospital to the highest cost sharing level will happen no more than once each calendar year. For help in finding a network* general hospital for which you pay the lowest cost sharing level, check the most current provider directory for your health plan option or visit the online provider search tool at www.bluecrossma.com/hospitalchoice. Then click on the Planning Guide link on the left navigation to download a printable network hospital list or to access the provider search page.
* - For the PPO plan designs, the different levels of cost sharing apply to in-network benefit levels at preferred general hospitals.