Benefits

Blue Cross Blue Shield Transition Plan

This plan is only available when there is a mix of Medicare and non-Medicare enrolled family members on the plan.  This plan combines basic Blue Cross Hospital, Blue Shield Medical/Surgical with Master Medical benefits in one plan.  Benefits are paid at 100 percent of the approved fixed fee amount to participating providers.  Payment levels from BCBSM for participating and non-participating providers are the same.  The Master Medical portion provides cost-sharing benefits for medically necessary expenses, which may not be covered by the BCBSM Basic plan.

Please Note:  Any residual charges from non-participating providers from the Basic plan above the approved fixed fee amount cannot be submitted to Master Medical for reimbursement.  Master Medical benefits are reimbursed after an annual deductible of $100 per individual $200 per family for support staff and $150 per individual $300 per family for faculty, academic staff and executive management.  Master Medical usually reimburses 80 percent of eligible claims after the required deductible, and 100 percent once the $1000 out-of-pocket maximum has been met.  Master Medical benefits have a lifetime maximum of $1 million.  Outpatient mental health benefits are reimbursed at 50 percent of the reasonable and customary amount, after the deductible, and are limited to 25 visits in a calendar year.