Mhbp Find A Provider

Mhbp Find A Provider – 1 MHBP (Mailmasters Benefit Plan) fee for service plan (Standard Option and Value Plan) and preferred provider organization. Sponsored by: National Association of Postmasters, AFL-CIO, LIUNA Division. Who may enroll in this plan: All federal employees and beneficiaries who are eligible to enroll in the Federal Employees Health Benefits Program and are or are members or affiliated members of the National Post Mail Handlers Union, AFL-CIO, LIUNA Section. For changes to benefits, see page 9. If you are a member or associate member: If you are not a postal worker/retired member, you will automatically become an associate member of the National Union of Postmasters when you register with MHBP. There is no membership fee for members of the National Union of Postmasters, AFL-CIO, a division of LIUNA. Membership Fee: $42 per year for associate membership unless exempted by law. New affiliate members will be billed annual dues by the National Association of Postmasters when the plan receives membership notification. Sustaining affiliate members will be billed by the National Association of Postmasters for an annual membership. Enrollment Codes for this Plan: 414 Value Plan – For Self Only 415 Value Plan – For Self and Family Other URAC Certifications: Caremark, Inc.: Pharmacy Benefit Management, Drug Therapy Caremark Rx, LLC: Specialty Pharmacy, -Mail Service Pharmacy 454 Standard Choice – Self Only United Behavioral Health, Houston Care Advocacy: Health Care Management 455 Standard Choice – Self and Family For additional approval information, see the 2012 Guide. Special Note: Information on the MHBP consumer option can be found in a separate See brochure RI RI

2 Important Notice from MHBP About Our Prescription Drug Coverage and Medicare OPM has determined that, on average, MHBP prescription drug coverage will cost the same as Medicare prescription drug coverage. -Medicare pays for all plan participants and is considered liability insurance. This way, you don’t have to enroll in Medicare Part D and pay extra for prescription drug benefits. If you later decide to enroll in Medicare Part D, you won’t have to pay a late enrollment penalty as long as you keep your FEHB coverage. However, if you choose to participate in Medicare Part D, you can keep your FEHB coverage and coordinate benefits with Medicare. Remember, if you are a beneficiary and cancel your FEHB coverage, you will not be able to re-enroll in the FEHB program. Please note that if you lose or give up your FEHB coverage and are without access to prescription drug coverage for 63 days or more, your premium will increase by at least 1% per month for each month you have at least is as good as prescription drug insurance coverage. I don’t have this insurance coverage. For example, if you go 19 months without Medicare Part D prescription drug coverage, your premium will still be 19 percent higher than what other people pay. You will have to pay this high premium as long as you have prescription drugs covered by Medicare. Additionally, you can also wait until the next annual adjustment election period (October 15 to December 7) to enroll in Medicare Part D. Medicare Low Income Benefit Additional help paying for the Medicare drug plan is available for those with limited income and benefits. For information about this program, contact the Social Security Administration (SSA) online or call the SSA at (TTY). For more information about the Medicare drug plans and coverage offered in your area, visit the following locations: Visit Personal Care, call MEDICARE ( ), ( TTY ). MHBP Notice of Privacy Practices We will protect the privacy of your protected health information as described in our most recent MHBP Notice of Privacy Practices. You can obtain a copy of our notice by calling us or visiting our website:

Mhbp Find A Provider

Mhbp Find A Provider

3 Table of Contents Introduction…3 Clear Language…3 Stop Healthcare Fraud!…3 Prevent Medical Errors…4 Section 1. Fee-for-Service Plan Facts…7 Section 2. How we are changing in Part 3. How to get benefits… 11 ID cards… 11 Where to get covered care benefits… 11 What you need to do to get covered care benefits…-1 You definitely need prior planning approval. Services…13 Section 4. Your Costs for Covered Services…18 Payment…18 Cost Sharing…18 Deductibles…18 Coinsurance…18 If Your Provider Regularly Waives Your Costs… .19 Cancellation…19 Liability for Differences…19 Your Catastrophic Coverage, Maximum Coinsurance Out of Pocket…20 Transfer…21 If We Pay More…21 If Government Agencies Charge Us Fees…21 If the Original Medicare Plan (Part A, Part B, or both)…22 Section 5. Standard Value Plan Options and Benefits…24 Non-FEHB Benefits Available to Plan Members…74 Section 6. General Exclusions from Our Offer Have You Have Insurance Coverage…77 Section 7. Making a Claim for Covered Benefits…79 Section 8. Disputed Claim Procedure…82 Section 9. Adjusting Benefits and Other Benefits…84 If You Have Other Health Care Benefits. …84 What is Medicare?…84 Should I enroll in Medicare?…85 The original Medicare plan (Part A or Part B)…85 A private contract with your doctor…86 Medicare Advantage (Part C …86 Prescription Medicare (Part D) …86 TRICARE and CHAMPVA …89 Workers’ Compensation …89 Medicaid …89 When other government agencies are responsible for your care …89 When others are responsible liable for injuries…89 Section 10. Definitions of terms we use in this guide…92 Section 11. FEHB Facts…97 Complete information…0 There is no state boundary.. .97 Where Information can be found in Registration for the FEHB program MHBP (Mail Operators Benefit Plan) 1 Table of Contents

Patient Safety Awareness Week Cut Out Stock Images & Pictures

4 Types of Insurance Available to You and Your Family…97 Children’s Equity Act…98 When Benefits and Premiums Start…99 When You Retire…99 When You Lose Benefits…0 When the FEHB protection ends. .99 After Divorce…99 Temporary Continuation (TCC)…99 Conversion to Individual Coverage…99 Obtaining Certification of Group Health Insurance Plan Under Section 12. Other Federal Programs MHBP Pricing Plan Overview MHBP Standard Option Tax Benefits MHBP Rate Information MHBP (Mail Carriers Benefit Plan) 2 Table of Contents

5 Introduction This brochure explains the benefits of the Mail Handlers Benefit Plan (MHBP). The National Post Mail Handlers Union, a division of LIUNA, and AFL-CIO, a division of LIUNA, have entered into a contract (CS1146) with the United States Office of Personnel Management pursuant to the Federal Employees Benefit Act. This plan is underwritten by First Health Insurance Company and Cambridge Life Insurance Company. The administrative office address is: MHBP PO Box 8402 London, KY This brochure is an official Statement of Work. No oral statement shall modify or affect the benefits, limitations and exclusions of this manual. It is your responsibility to learn about your health benefits. If you participate in this program, you will be entitled to the benefits described in this brochure. If you are enrolled in personal and family insurance, each eligible family member is also entitled to these benefits. You are not entitled to benefits that existed before January 1, 2012, unless these benefits are also listed in this brochure. OPM negotiates benefits and pricing for each plan annually. The service changes come into effect on January 1, 2012 and are summarized on pages xxx-xxx. You can find the prices at the end of this brochure. Simple language All FEHB manuals are written in simple language for easier understanding. Here are some examples: In addition to the necessary technical terms, we use common technical terms. For example, if you mean the enrollee or a family member, we mean MHBP. We’ll narrow down the acronyms to the ones you know. FEHB is the Employee Health Benefits Program. OPM is the U.S. Office of Personnel Management. When we use others, we first tell you what they mean. Our brochure and other FEHB plan brochures have the same format and descriptions to make it easier for you to compare plans. If you have comments or suggestions to improve the quality of this guide, please let OPM know. Visit OPM’s Quick Comments section here or OPM at fehbwebcomments@opm.gov. You can also write to OPM: US Office of Personnel Management Healthcare and Insurance, Federal Employee Insurance Operations, Program Analysis and Programs Support, 1900 E Street NW, Washington, DC Stop healthcare fraud! Fraud increases healthcare costs for everyone and increases your Employers Health Benefits Program premium. OPM’s Office of Inspector General investigates all allegations of fraud, waste, and abuse within the FEHB program, regardless of the agency that hired you or from which you left. Protect yourself from fraud. Here are some things you can do to prevent fraud: Do not give your plan ID number over the phone or to strangers, except to your doctor, another provider, or an authorized plan or OPM. Representative. Only allow qualified healthcare professionals to view your medical records or recommend services. Avoid using health care providers who do not pay for an item or service but know how to bill us for payment. Carefully review the service bills (EOBs) you receive from us. Please check your claims history

Leave a Comment