Health Care Benefits - Healthy Blue Living HMO Plan
Western Michigan University's Healthy Blue Living HMO health plan is administered by Blue Care Network of Michigan. Benefits may include medical, prescription drug, dental and vision. Dental and vision benefits are administered by BCBSM partners.
TRANSPARENCY IN COVERAGE RULE
The link below leads to the machine readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data. Please note that the files are large, please check your system capacity before downloading.
Payer Transparency machine-readable files
Healthy Blue Living HMO network providers
Register for BCBSM to search for physicians, hospitals, and other healthcare providers in the Health Blue Living HMO network.
- As an HMO member, you'll choose an in-network primary care physician (PCP) in Michigan who will coordinate your health care services.
- You must get a referral from your PCP in order to seek care from a specialty provider.
- Learn how to compare and choose a health care provider.
Benefit levels
- The Standard benefit level has higher deductibles, coinsurance, and out-of-pocket maximums than the Enhanced benefit level.
- If you enroll in the HMO plan, you will automatically be enrolled in the Enhanced benefit level. To maintain the Enhanced benefit level for the remainder of the plan you, you must complete the requirements below. Other covered family members are not required to participate.
- The qualification form helps you and your doctor get a snapshot of your health based on six high impact health measures (tobacco, weight, blood pressure, cholesterol, blood sugar, and depression). Download and print the form by logging into your BCBSM account.
- You will receive a Healthy Blue Living HMO Member Guide at your home shortly after you enroll.
BCN Health Tools
Blue365 - deals on weight loss programs, hearing aids, eye care services and much more that is exclusive only to BCN members!
Blue Cross Health and Wellness for Blue Care Network (powered by WebMD).
- Member Overview
- Health and Wellness Assessment
- Digital Health Assistant
- Daily Victory and Weight Today Mobile Apps
On-campus health care
Health care services are available on campus at Unified Clinics You may also use the Sindecuse Pharmacy.
Prescription drug coverage
Your prescription drug benefit is provided through Blue Cross Blue Shield of Michigan's prescription drug program.
- BCBSM Custom Drug List (Formulary) and any Custom Drug List updates.
- BCBSM Pharmacy FAQ's- answers to questions regarding prior authorization, step therapy, and specialty drugs.
Sindecuse Pharmacy - a full-service pharmacy offering a complete range of prescription medications and a number of over-the-counter non-prescription items.
submitting claims
For claims you must submit yourself, complete the appropriate form, sign, and mail with original receipts to the address provided on the claim form.
need more help?
Contact Blue Care network for coverage and claims information concerning medical, prescription drug, vision, or dental benefits.
- BCN Customer Service: (800) 662-6667
- Meet with a BCN/BCBSM representative on campus most Thursdays. You can also consult with the representative via phone call. Call (269) 387-3620 to make an appointment.
additional Resources
- Benefit Notices
- Blue Care Network Healthy Blue Living HMO Overview - what it is and if it's right for you.
- Blue Care Network Health Care Coverage Travels - your BCN coverage travels with you.
- Blue Care Network's Woman's Choice Program
- HIPAA - establishes certain privacy rights regarding employees' personal health information.
- Preventive Care Recommendations - identify the preventive services you need and at which age you need them.