Southwest Human Development offers four medical plan options through Blue Cross Blue Shield of Arizona (BCBSAZ) national PPO network.
Before you enroll in medical coverage, take some time to fully understand how each plan works. Refer to pages 6 and 7 for an overview of the plan benefits.
BEFORE YOU CHOOSE A PLAN, CONSIDER THIS:
When choosing your medical plan it is important to consider the total costs—including the premiums you pay for the coverage and what you pay when you use the benefits.
*Note: Some prescription drugs are considered preventive and are covered at 100%. Visit https://fm.formularynavigator.com/fbo/68/prevention_drug_list.pdf to view the medications that are required under the ACA to be covered at 100% (all non-grandfathered health plans). In addition, BCBSAZ CDHP members may visit https://fm.formularynavigator.com/fbo/68/hsa_preventive_drug_list.pdf to view the HSA Expanded Preventive RX listing.
MEDICAL COSTS
Listed below are the per pay period costs for medical insurance. The amount you pay for coverage is deducted from your paycheck on a pre-tax basis.
The table below summarizes the benefits of each medical plan.
The plans offer in- and out-of-network benefits, providing you the freedom to choose any provider. However, you will pay less out of your pocket when you choose a network provider. Locate a BCBSAZ network provider at azblue.com/member.
The coinsurance amounts listed reflect the amount you pay. Please refer to the official plan documents for additional information on coverage and exclusions.
(1) If you elect employee + spouse, employee + child(ren), or family coverage, the individual deductible and out-of-pocket maximum apply to each covered member of the family (capped at family amount). (2) Includes approved maintenance medications. List available online.
Note: Under the BCBSAZ CDHPs, maintenance medications are covered 100%. Please refer to BCBSAZ’s list of preventive drugs for more information.
ALLIANCE NETWORK
If you enroll in the BCBSAZ Alliance CDHP, you will have access to the Alliance network—a convenient network of doctors and providers available to residents of Maricopa and Pinal County. This network features utilizes doctors and hospitals affiliated with Banner Health and HonorHealth. To help keep your costs low, please access providers, labs, and facilities within the Alliance network. To find an Alliance network provider, log into azblue.com/findadoctor or download the MyBlue AZSM app and select the Alliance network in the Find a Doctor tool.
The table below summarizes the benefits of each medical plan.
The plans offer in- and out-of-network benefits, providing you the freedom to choose any provider. However, you will pay less out of your pocket when you choose a network provider. Locate a BCBSAZ network provider at azblue.com/member.
The coinsurance amounts listed reflect the amount you pay. Please refer to the official plan documents for additional information on coverage and exclusions.
(1) If you elect employee + spouse, employee + child(ren), or family coverage, the individual deductible and out-of-pocket maximum apply to each covered member of the family (capped at family amount).
BLUECARE ANYWHERE TELEHEALTH
BlueCare Anywhere offers all employees enrolled in a BCBSAZ medical plan access to virtual visits with board-certified physicians, counselors, and psychiatrists using your smartphone or computer. Virtual visits are available 24/7 and can be conducted anywhere within minutes of a visit request or by appointment.
Use BlueCare Anywhere to talk to a doctor about treating a wide range of physical and psychological care needs, including flu, sore throat, cough/cold, migraines, panic attacks, depression, insomnia, anxiety, and more.
Enroll on bluecareanywhereaz.com or download the BlueCare Anywhere mobile app to get your appointment today.
The amount you pay for care is based on the plan you enroll in:
- BCBSAZ PPO $2,500 and BCBSAZ PPO $1,500 members pay a $10 copay for medical visits, a $20 copay for counseling visits, and a $20 copay for psychiatric visits.
- BCBSAZ CDHP and BCBSAZ Alliance CDHP members pay $67 for medical visits, $96–$122 for counseling visits, and $98–$263 for psychiatric visits.
NURSE ON CALL
Nurse On Call is there when you need help, 24/7, at no additional cost to you. Nurses can help you decide where to go for care and provide answers to your health questions on current symptoms, chronic conditions, preventive care, and medications.
Ready to speak with a nurse? Call 866-422-2729 or chat with a nurse online:
- Log on to your member portal at azblue.com/healthyblue.
- Click on Nurse on call home and start a live chat.
TERMS TO KNOW
In-network preventive care is free for medical plan members.
The cost of your preventive care is covered 100% by the Southwest Human Development medical plans. This means you won’t have to pay anything out of your pocket.
SAVE MONEY ON YOUR HEALTH CARE
Note: Some services are generally not considered preventive if you get them as part of a visit to diagnose, monitor, or treat an illness or injury. Please be aware that you will be responsible for the cost of any non-preventive care services you receive at your preventive care exam based on your plan design. Learn more about preventive care at azblue.com.
Know where to go for your health care.
Where you go for medical services can make a big difference in how much you pay and how long you wait to see a health care provider. Use the chart below to help you choose where to go for care.
WELLNESS PROGRAMS
Southwest Human Development offers two wellness programs—BCBSAZ Sharecare for medical plan members and LifeWorks for non-medical plan members.
BCBSAZ SHARECARE
If you are enrolled in a BCBSAZ medical plan, you have access to Sharecare—a digital health solution that offers personalized insights, challenges, daily tracking, and one-of-a-kind tools to help you live healthier, no matter where you are in your health journey. When you participate in the Sharecare wellness program, you can earn points to redeem for rewards.
Start by taking the RealAge health assessment to calculate your body’s true age based on your current health habits and how you feel. The Sharecare RealAge program will keep you on track toward your health goals with fun reminders and tools that keep you engaged.
Use the RealAge program to:
- Access your essential health information, including your prescriptions, medical conditions, and test results all in one place.
- Get personalized health recommendations, curated wellness challenges, and health-focused articles and videos to guide you on your journey toward better health.
- Stay motivated with expert guidance and accountability when you need it, with achievable goals and rewards that help you lower your RealAge.
You must complete a biometric screening and the RealAge health assessment to start earning points that you can redeem for rewards. No information is ever shared with Southwest Human Development.
Download the Sharecare mobile app or visit azblue.sharecare.com to get registered. If you have questions or need assistance registering, contact Sharecare at 877-292-1359.
HEALTH ADVOCATE
Health Advocate is provided to you and your family members including your spouse/domestic partner, dependent children, parents, and parents in-law AT NO COST.
With Health Advocate, you have unlimited, confidential access to a Personal Health Advocate who can assist you with a wide variety of health care and insurance-related issues, no matter how long it takes.
Your personal Health Advocate can help:
- Find an in-network doctor, specialist, or hospital.
- Answer questions about your benefits and coverage, including medical, prescription, dental, and vision.
- Resolve claims and billing issues to avoid duplicate or excessive charges.
- Clarify the total and out-of-pocket costs for services, including deductibles, coinsurance, and copays.
- Assist with referrals, prior authorization, and prescription drugs.
- Navigate health care reform laws.
- Schedule appointments for you, your spouse, your dependents, and even your in-laws.
- Answer questions about test results, treatments, and medications to help you make informed decisions.
- Assist with second opinions and transferring medical records.
- Locate elder care services.
For assistance, call 866-695-8622, email answers@healthadvocate.com, visit healthadvocate.com/members, or download the Health Advocate app for support anywhere you are.
HERE’S HOW HEALTH ADVOCATE WORKS:
