highmark ppo blue benefits booklet 2022

0000005546 00000 n 0000151828 00000 n The contract is in effect for months in which you are enrolled in Freedom Blue PPO Standard between January 1, 2022 and December 31, 2022. 0000108301 00000 n If you have questions regarding how we process your Personal Data and what we store about you, please contact PrivacyInternational@HighmarkHealth.org or write us: By agreeing to the terms and conditions set out in this Data Protection Statement, and by providing us with your Personal Data, you consent to the collection, use and disclosure of any information you provide in accordance with the above purposes and this Data Protection Statement. <> 1636 0 obj 68 0 obj Our team is working hard to get you your OTC items, however we are experiencing a labor shortage and an abnormally high number of out-of-stock items. endobj Learn more about your OTC Benefit and this site by visiting theMy Accountpage. Arthritis Pain Relief Tablets APAP 650mg 24 ct. (ii) when required valid requests by law enforcement. Next year, there will be some changes to the plan's costs and benefits. 3. Next year, there will be some changes to the plan's costs and benefits. Your plan documents also provide complete information to submit a claim appeal or a grievance for any reason to your plan. (iii) for purposes relevant to corporate policies or litigation to the extent permitted under applicable law or when it is prescribed in GDPR or other applicable law. <>stream 0000107522 00000 n <>/ProcSet[/PDF/ImageC/Text]/XObject<>>> 0000151927 00000 n Welcome to your 2022 Over-the-Counter Benefit, administered by Fieldtex. 84 0 obj 0000050371 00000 n The purpose of this Data Protection Statement is to notify you of the practices that will govern the processing of your personal data and to obtain your explicit consent for the processing of your personal data consistent with it, in particular in accordance with the legal requirements of the European Unions (EU) General Data Protection Regulation (GDPR): The personal data collected may include your address, city, postal code, country, phone number, email address, IP address, as well as any other personal information you choose to provide (Personal Data). 79 0 obj blue diabetic medicine as long as you read the diabetes medicine used in the 1700s history of the ancient and modern, you can understand that there are various hard seltzer ,& ~: RyO[aK@e~@q7F lXu x@ Ij Due to increased demand during the COVID-19 outbreak, we have placed quantity limits on certain items. The OTC Benefit is designed to give you access through your health plan to preventative health products that you are already using at no additional cost to you. Phone: 800-672-6365 Fax: 605-343-4927. (i) when required or permitted by law or government agencies. endobj effective January 1, 2023 and will be locked in for the entire year, unless you have a Qualified Life Event. Consult your OTC catalog. hbbd``b`z$@C $X[` @Ta "$xDf# 8/@ Pretty simple. 922-00304 - Biotene dry mouth oral rinse 16 fl. Complete Blue PPO Summary of Benefits January 1, 2022 to December 31, 2022 The service area for these plans includes the following counties: Allegheny, Armstrong, Beaver, Butler, Cambria, Fayette, Greene, Indiana, Washington, Westmoreland To enroll in the following plans, you need to be entitled to Medicare Part A, enrolled in Medicare take the time to review this booklet; it contains important information about your health insurance, including: how to use your member id card the importance of selecting a provider of record getting quality care and service definitions of common health care insurance terms the outline of coverage and member agreement for your plan if These services providers are located in the United States. 0000008918 00000 n These service providers will be bound by sufficient guarantees to implement appropriate technical and organizational measures in such a matter that their processing will meet the requirements of applicable law. This plan features a high performance network focused on low-cost, high-quality providers. H3916_21_3149_M . You can also receive a paper copy of your SBC (s) free of charge upon request. Inpatient hospital - psychiatric. 0000005907 00000 n We hope that you enjoy the selection of products and the convenience of the service. <>stream 2022 Pharmacy Mail-Order Form . ClassicBlue Comprehensive lets you receive care from any doctor or hospital you want. During the Election period from October 1, 2022 through November 30, 2022 you have the option to change your . trailer To access an SBC, please choose a plan from the list above. 1631 36 endobj 0000007900 00000 n This means we can change the costs and benefits of Freedom Blue PPO Standard after December 31, 2022. We hope that you enjoy the selection of products and the convenience of the service. endstream You also explicitly consent to the automated decision making by us, which may include the processing of your health data, to the extent that it is necessary to process your health claim swiftly and efficiently. 0000001424 00000 n 1637 0 obj (ii) when required valid requests by law enforcement. 0000150882 00000 n 0000001016 00000 n Highmark Blue Shield Formulary Use The drug formulary is divided into major therapeutic categories for easy use. endobj You also explicitly consent to the automated decision making by us, which may include the processing of your health data, to the extent that it is necessary to process your health claim swiftly and efficiently. The SBC shows you how you and the would This information will be used for purposes of performing services to, or on behalf of, our enterprise customers and prospective customers as part of and in relation to matters regarding our provider, health plan, and subsidiary enterprise care delivery, administration and operations. oz. 1633 0 obj At Highmark Blue Cross Blue Shield of Western New York, we offer a number of different individual and family plans. <>stream 0000006320 00000 n Maximum out-of-pocket enrollee responsibility (does not include prescription drugs) $10,000 In and Out-of-network / $6,500 In-network Optional supplemental benefits No Additional benefits. 4. This booklet tells about the changes. Up_22_u~^]Om*j*@".%`aQ'lg 4'mqlVxu=kkx7Z)EY7M^3Ay89/MpRTAQBlmlGgO-x~:1/C9@m6a8Nh}.^q3@>JYY:?zk ],2)osx_cL"#;9Dw5!@={:PlmJw<9Gs0N9d0x*HkIHBi _!A@N1EN6mSJ?C8w4>Gk}3&~4V$d'?Ew&O@1mD{ |}=ir~GS/oD7/yFfE[ 3K 0000000016 00000 n This information will be used for purposes of performing services to, or on behalf of, our enterprise customers and prospective customers as part of and in relation to matters regarding our provider, health plan, and subsidiary enterprise care delivery, administration and operations. Freedom Blue PPO Distinct (PPO) offered by Highmark Senior Solutions Company Annual Notice of Changes for 2022 You are currently enrolled as a member of Freedom Blue PPO Distinct. Penn State Health. xref You have from October 15 until December 7 to make . 922-10673 - Mint flosser with pick 90 ct. 922-00352 - Interplak rechargable cordless toothbrush. endobj Dn3u. We 0000005115 00000 n <>/ProcSet[/PDF/Text]>>/Rotate 0/Type/Page>> <> %PDF-1.5 % grievance or appeal. Highmark Blue Shield provides certain administrative communications for this company. Highmark Freedom Blue Ppo Login will sometimes glitch and take you a long time to try different solutions. 1634 0 obj 69 0 obj You pay an additional $24 per month. endobj Take advantage of our low-cost premium plans, $0 copay for preventive services, and coverage that is recognized nationwide. <> 2022 Prescription Drug Claim Form . 0000007086 00000 n Highmark's mission is to be the leading health and wellness company in the communities we serve. We will retain the information in our system in accordance with applicable law and our Data Protection Policy:https://www.highmark.com/hmk2/gdpr.shtml. You are limited to ONE FREE SHIPMENT PER QUARTER, so be sure order all of your items at the same time. hKO0=v+xBDZ( - Y(43/o AEF*^5`"YsUT-XDcy^^7{~Q.oZLUl,U;.fSid\ These service providers will be bound by sufficient guarantees to implement appropriate technical and organizational measures in such a matter that their processing will meet the requirements of applicable law. Important Information: All products have an ordering limit of three units per Quarter, unless otherwise specified. 0 Some of the great health care providers Performance Blue members have access to include: Allegheny Health Network. Your email address and phone number may be used to contact you. Our plan has additional coverage limits for certain benefits. If you use the The SBC makes it easier for you to understand your health care benefits, find out what's covered, and compare various plans. For more information about your rights, look at the explanation of benefits you will receive for that medical claim. endobj 0000003996 00000 n <>/Border[0 0 0]/Rect[307.848 215.447 445.788 226.708]/StructParent 1/Subtype/Link>> If you have questions regarding how we process your Personal Data and what we store about you, please contact PrivacyInternational@HighmarkHealth.org or write us: By agreeing to the terms and conditions set out in this Data Protection Statement, and by providing us with your Personal Data, you consent to the collection, use and disclosure of any information you provide in accordance with the above purposes and this Data Protection Statement. Freedom Blue PPO Classic (PPO) offered by Highmark Senior Health Company Annual Notice of Changes for 2022 You are currently enrolled as a member of Freedom Blue PPO Classic. oz. 1 of 10 Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2022 - 12/31/2022 Highmark Blue Cross Blue Shield: my Priority Blue Flex EPO Gold 0 Coverage for: Individual/Family Plan Type: EPO endobj my Blue Access PPO Bronze 3800 ONX Base Jan I_76168DE0690001-01_20220101_SBC The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 0000151804 00000 n 0000107278 00000 n Notwithstanding the above disclosures, we will disclose the Personal Data we collect from you under the following circumstances: We use third-party service providers to process Personal Data, including, without limitation, for information storage and other similar purposes. All reasonably appropriate measures will be taken to prevent disclosure of your Personal Data beyond the scope provided directly or indirectly herein or as may be reasonably inferred from the content contained in this notice or the website. The Covid-19 crisis has presented challenges that have negatively impacted the current supply chain and workforce. Identify approved items in the catalog. When members stay in network, they usually pay less out of pocket. 1638 0 obj Each calendar year, Medicare allows us to make changes to the plans that we offer. <<22FFE2A32DB2B2110A00603A64EBFF7F>]/Prev 387284>> endstream 0000007459 00000 n 0000151890 00000 n If you require special assistance, including accommodations for disabilities or limited English proficiency, please call us at 1-800-876-7639 or TTY at #711 to receive assistance free of charge.. Highmark Blue Cross Blue Shield is an independent corporation operating under licenses from the Blue Cross and Blue Shield Association. %%EOF endobj 0000003575 00000 n We thank you for your continued support and patience and apologize for any inconvenience this may cause. Highmark Blue Cross Blue Shield is an independent corporation operating under licenses from the Blue Cross and Blue Shield Association. %%EOF Forever Blue (PPO) (H5526) Summary of Benefits Freedom Nation (PPO) (H5526) Summary of Benefits Additional information regarding your coverage Booklet Contents 16382_08_2021 2022 MEDICARE ADVANTAGE Y0086_COM691_C. LoginAsk is here to help you access Highmark Freedom Blue Ppo Login quickly and handle each specific case you encounter. 0000002051 00000 n 65 0 obj <>/Metadata 1629 0 R/Names 1633 0 R/OpenAction[1634 0 R/Fit]/PageLabels<>]>>/PageMode/UseNone/Pages 1628 0 R/StructTreeRoot 36 0 R/Type/Catalog/ViewerPreferences<>>> Your Personal Data will remain on file for: any period required by applicable law; and, to the extent necessary for any purpose(s) provided directly or indirectly herein or as may be reasonably inferred from the content contained in this notice or the website, but no longer than permitted by applicable law. x 2 in. %PDF-1.6 % 0000002452 00000 n For ordering assistance, please call1-855-913-0889 (TTY: 711) Monday - Saturday from 8 a.m. to 5 p.m. and Sunday from 10 a.m. to 5 p.m. These hurdles are unfortunately resulting in longer than usual order delivery times. 2. Go to the OTCHS section of the store or look for the blue labels identifying eligible approved products. After that, all Personal Data will be deleted or the documents with such data will be anonymized. Diagnostic Equipment - Blood Pressure Monitors, Dentek Instant Oral Pain Relief 50/Applications, Interplak Rechargeable Cordless Toothbrush. 0000001717 00000 n iVk%peb7k\F7XEmb2/MVh-,wee]V ~2{\eGV^yLqa@V 1Ou}k-n; mbHatk :Qu"=,BGy 8 Clz.LD gRKgEp8-9/kYi'{#N(}|.e!RTP?U Go to any select approved participating OTCHS enabled CVS Pharmacy, CVS Pharmacy y ms, or Navarro store. Community Blue Medicare PPO Summary of Benefits January 1, 2022 to December 31, 2022 The service area for these plans includes the following counties: Adams, Berks, Cumberland, Dauphin, Lackawanna, Lebanon, . 1635 0 obj Highmark medicare otc catalog 2022 1. Your email address and phone number may be used to contact you. Please check the right column on this page to see your current benefit allowance and schedule. Once the national emergency has passed and inventory levels return to normal, these restrictions will be lifted. Prescription Fax Form . plan costs) reach $4,431. <>/Filter/FlateDecode/ID[<41754A555FB3B2110A0020E9E992FD7F>]/Index[65 20]/Info 64 0 R/Length 74/Prev 419708/Root 66 0 R/Size 85/Type/XRef/W[1 2 1]>>stream gives your Freedom Blue PPO members in-network access to doctors and . 1631 0 obj 922-10487 - Curad flexible assorted bandages 100 ct. 922-00303 - Dentek instant oral pain relief 50/applications. This will not affect those groups that provide a benefit for prescriptions through the Coverage Gap. endobj endobj 2022 Authorization to Disclose Protected Health Information (PHI . 66 0 obj hb```"*Ad`f`s,0`v`lx(?R"n0 qbW6? Arthritis Pain Diclofenac Gel 1% 3.53 oz. This booklet tells about the changes. 0000108277 00000 n Summary of Benefits H3384 . The OTC Benefit is designed to give you access through your health plan to preventative health products that you are already using at no additional cost to you. Furthermore, you can find the "Troubleshooting Login Issues" section which can answer your unresolved problems and . 2022 Summary of Benefits Highmark Blue Cross Blue Shield BlueSaver (HMO) (2022) 0000004568 00000 n To access Community Blue Medicare HMO's online provider directory, you can visit medicare</b>.highmark.com. - generic, 922-90575 - Best fiber powder sugar free 62 servings. Products that are approved for more than one therapeutic indication may be included in more than one category. Notes: This consent is given voluntarily and can be revoked at any time in writing by sending an email to PrivacyInternational@HighmarkHealth.org If you want to exert your withdrawal right or your rights to access, rectify, block, transfer or delete your personal data pursuant to the GDPR, please contact us and provide us at least with your full name, address and the data processing you are inquiring about. (i) when required or permitted by law or government agencies. Out-of-Network: $475 per day for days 1 through 3 / $0 per day for days 4 . endstream FOR CURRENT HIGHMARK PPO BLUE PLAN MEMBERS . highmark freedom blue ppo diabetic medicine awarded mankind diabetes medicine to someone who has established special merits in the military pancreas and glucose or culture. Your Personal Data will be disclosed to appropriate personnel for purposes of performing services to, or on behalf of, our enterprise customers and prospective customers as part of and in relation to matters regarding our provider, health plan, and subsidiary enterprise care delivery, administration and operations. <>/MediaBox[0 0 612 792]/Parent 1628 0 R/Resources 1636 0 R/Rotate 0/StructParents 0/Tabs/S/TrimBox[0 0 612 792]/Type/Page>> seven days a week or visit medicare.highmark.com. NORTHWESTERN PENNSYLVANIA . Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2022 - 12/31/2022 F and M Trust Co.: PPO Blue Coverage for: Individual/Family Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. endobj 0 <>stream If you are not satisfied with our data processing you have the right to lodge a complaint to the data protection authority in your country of residence. Highmark Wholecare serves a Medicaid plan to Blue Shield members in 13 counties in central . 0000004432 00000 n startxref Highmark Blue Shield participating providers accept the amount Highmark pays for covered services as payment in full. 200 ct. 922-10800 - Hand sanitizer with pump 8 oz. Community Blue Medicare HMO's network providers in your area, you can visit medicare . endobj HWKo8WbD"Aw/E mr# Xy}m(4pjv;1ZdQ highmark .com or call our Customer Service Department at 1-888-234-5397, Monday through Sunday, 8:00 a.m. to 8:00 p.m. TTY users should call 711. 0000002193 00000 n For plans purchased on the Health Insurance Marketplace please call 1-888-510-1084 . Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2022 - 12/31/2022 Highmark Delaware: my Blue Access PPO Premier Gold 0 + Adult Dental and Vision Coverage for: Individual/Family Plan Type: PPO 922-10782 - Aleve easy open cap 220mg caplets 90 ct. 922-10734 - Arthritis pain relieving gel 1% 3.53 oz. Most dosage forms and strengths of a drug are included in the formulary. 0000008143 00000 n These services providers are located in the United States. Your Personal Data will remain on file for: any period required by applicable law; and, to the extent necessary for any purpose(s) provided directly or indirectly herein or as may be reasonably inferred from the content contained in this notice or the website, but no longer than permitted by applicable law. PPOBlue pays benefits at a higher level when you use network providers and at a lower level when you use out-of-network providers. 1 of 10 Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2022 - 12/31/2022 Highmark Blue Shield: my Blue Access PPO Bronze 3800 Coverage for: Individual/Family Plan Type: PPO endobj All reasonably appropriate measures will be taken to prevent disclosure of your Personal Data beyond the scope provided directly or indirectly herein or as may be reasonably inferred from the content contained in this notice or the website. <> Out-of-Pocket Cost threshold to reach Catastrophic Coverage will . 0000006940 00000 n Highmark Blue Shield and Highmark Senior Complete Blue PPO has a network of doctors, hospitals, pharmacies, and other providers. The purpose of this Data Protection Statement is to notify you of the practices that will govern the processing of your personal data and to obtain your explicit consent for the processing of your personal data consistent with it, in particular in accordance with the legal requirements of the European Unions (EU) General Data Protection Regulation (GDPR): The personal data collected may include your address, city, postal code, country, phone number, email address, IP address, as well as any other personal information you choose to provide (Personal Data). We will retain the information in our system in accordance with applicable law and our Data Protection Policy:https://www.highmark.com/hmk2/gdpr.shtml. 0000001680 00000 n 922-00050F - Alcohol wipes 1 in. Highmark Preventive & Bright Futures Schedule. Drugs are listed by brand and generic names. 0000151116 00000 n *0iNbm3}RD2&-.g:=,4 ,FA 0Q AT9: t `103Z0T0$031q23c(beP.0c The benefits are the same in both the Highmark PPO Blue and Highmark . 922-10485 - A & D ointment 15 oz. 922-90601 - Arthritis pain relief tablets APAP 650mg 24 ct. Notwithstanding the above disclosures, we will disclose the Personal Data we collect from you under the following circumstances: We use third-party service providers to process Personal Data, including, without limitation, for information storage and other similar purposes. 0000050396 00000 n hb```B cr r&``K8,p\U(@iB ]hd_VUV#3\ <>stream (iii) for purposes relevant to corporate policies or litigation to the extent permitted under applicable law or when it is prescribed in GDPR or other applicable law. Save more on high-quality care. After that, all Personal Data will be deleted or the documents with such data will be anonymized. Biotene Dry Mouth Oral Rinse Mint 16 fl. Your Personal Data will be disclosed to appropriate personnel for purposes of performing services to, or on behalf of, our enterprise customers and prospective customers as part of and in relation to matters regarding our provider, health plan, and subsidiary enterprise care delivery, administration and operations.

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