nc state health plan vision coveragenc state health plan vision coverage

Our health benefit plans have exclusions and limitations and terms under which the coverage may be continued in force or discontinued. Eligibility. Once in Blue Connect, click Wellness at the top of the page. North Carolina health insurance plans | UnitedHealthcare Vision insurance helps cover eye exams, contacts, glasses and more. Preventive care services and medications are covered at 100% for State Health Plan members on all 3 plans [the Base PPO Plan (70/30), the Enhanced PPO Plan (80/20), and the High Deductible Health Plan]. Behavioral health benefits and services include: Tailored Plan benefits and services include: You can get these services from a provider outside of the health plans network, if the provider takes NC Medicaid: You can get these services from a provider in the health plans network: If you have questions, call us at1-833-870-5500(TTY: 711 or RelayNC.com). For information regarding Humana, call 888-700-2263 or visit their website. To find an in-network dietitian, use our Find a Doctor tool and search under "Specialist" for a licensed dietitian/nutritionist. For Colorado: The Network Access Plan, which describes an access plan specific to your network, is available by calling the customer service number found on your Humana Vision ID Card/Dental ID card and requesting a copy. Preventive care services and medications are covered at 100% for State Health Plan members on all 3 plans [the Base PPO Plan (70/30), the Enhanced PPO Plan (80/20), and the High Deductible Health Plan]. Click here to view the vision plan rates. NCFlex Vision Plan - Benefits, Employee Wellness and Work Life ' qwYkfM|b>_pqd'*UxZd1*U{=@\2|^EUG~4jSO4yAZQ!7N%#6ZjL. Our dental plans, vision plans, and life insurance plans may also have waiting periods. The Plan contracts with a Third Party Administrator, currently Blue Cross and Blue Shield of North Carolina, to provide a provider network and process health care claims. Using Your Sick Leave. Enhanced Plan: Enhanced Exam and Materials Resource Centers State Health Plan Resource Center Pharmacy Resource Center Diabetes Resource Center Behavioral Health Resource Center Eligibility. They process medical claims and oer a provider network, but taxpayers like you pay for your . Shop Health Insurance Plans in North Carolina Individual & Family Shop for a plan for yourself, your spouse or your family. As a new employee, we're here to help you navigate through your State Health Plan options. (This fee is non-refundable as allowed by state). For costs and complete details of coverage, call or write Humana or your Humana insurance agent or broker. In the event of a dispute, the policy as written in English is considered the controlling authority. Waiting periods may apply outside of the newly hired initial 30-day eligibility period. Some plans may also charge a one-time, non-refundable enrollment fee. To learn more, view our full privacy policy. To learn more, go to, Certified pediatric and family nurse practitioner services, Dietary evaluation and counseling and medical lactation services, Early and periodic screening, diagnostic and treatment services (EPSDT), Federally qualified health center services, Freestanding birth center services (when licensed or otherwise recognized by the North Carolina Department of Health and Human Services), Inpatient psychiatric services for individuals under age 21, Limited inpatient and outpatient behavioral health services, Prescription drugs and medication management, Speech, hearing and language disorder services, Tobacco cessation counseling for pregnant women, Early and periodic screening, diagnostic and treatment services (EPSDT) for members under age 21, Facility-based crisis services for children and adolescents, Medically supervised alcohol and drug abuse treatment center detoxification crisis stabilization, Non-hospital medical detoxification services, Outpatient behavioral health emergency room services, Outpatient behavioral health services provided by direct-enrolled providers, Professional treatment services in a facility-based crisis program, Research-based intensive behavioral health treatment for autism spectrum disorder, Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID) services, Traumatic Brain Injury (TBI) Waiver services, Transitions to Community Living (TCL) program services, Services provided by Childrens Developmental Services Agencies (CDSAs) or providers contracted with CDSAs that are included in your childs Individualized Family Service Plan (IFSP), Services provided before NC Medicaid eligibility determination. Note: Limitations and exclusions may apply, Humana legal entities that offer, underwrite, administer or insure insurance products and services. FDA-approved weight management medications and bariatric surgery are covered benefits. Under the Employee Self Service tiles>Click on the Benefit Details tile>Click on Enroll in Benefits (on the leftmake sure your pop up blocker is off). UnitedHealthcare vision insurance plans offer a variety of individual coverage options. Changes in tax laws or other requirements might cause changes in the plan. NC OSHR: State Health Plan PDF Your NORTH CAROLINA STATE HEALTH PLAN - files.nc.gov A lock icon or https:// means youve safely connected to the official website. Vision Insurance in North Carolina | Find Vision Coverage Options - Humana CVS Caremark Pharmacy Benefit Resource Center (for 70/30 members), New Joint Replacement Program Waives Deductibles, View a List of State Health Plan Forms (for 70/30 Plan members). Coverage begins the first of the month following your hire/start date or life event date. To learn more, view our full privacy policy. Secure websites use HTTPS certificates. Once logged into eBenefits, look for a link to Blue Connect in the left-hand menu. Skip to main content Insurance Plans Medicare and Medicaid plans Medicare In addition, all Plan members who are tobacco users and wish to enroll in PCP tobacco cessation counseling may do so. Employees must enroll within 30 days of their hire date or within 30 days of a qualified life event. Vision Care VisionCare This plan is administered by EyeMed Vision Care and underwritten by Fidelity Security Life Insurance. Discount plans are offered by HumanaDental Insurance Company, Humana Insurance Company, or Texas Dental Plans, Inc. Arizona residents insured by Humana Insurance Company. Offers change weekly. For information on requesting an external review of claims decisions (after all internal grievance procedures have been exhausted). If you have questions about the NCFlex benefits available to state employees, please contact your agency or university health benefits representative (HBR). Applicable fees are disclosed at time of enrollment. As a result, you will have to pay the additional premium for the month in which the child is born. Preventive services and medications are covered at 100% with this plan. Medicareeligible retirees of North Carolina State Health Plan will move to the Humana Medicare (Group) Preferred Provider Organization (PPO) plan for their healthcare coverage, effective Jan. 1, 2021. Go to article library You may also participate in the State Health Plan by paying the full cost . NCFlex MetLife Dental International Travel Assist Flyer. Learn more about Copays. 2023 NCFlex Dental Plan Details.pdf. Statements in languages other than English contained in the advertisement do not necessarily reflect the exact contents of the policy written in English, because of possible linguistic differences. Individual applications are subject to eligibility requirements. Benefits and services | NC Medicaid Managed Care Base PPO Plan (70/30) and Enhanced PPO Plan (80/20) Members: Adult and child (age 6+) nutrition and weight management services are included under the Affordable Care Acts preventive services, meaning that they are covered at 100% for members on the Base PPO Plan (70/30) and Enhanced PPO Plan (80/20). 2022 NCFlex Vision Plan Details.pdf. EyeMed NCFlex Hearing Discount Flyer.pdf. See if your current vision care provider is in our network. A minimum one-year, initial contract period may be required for some dental and vision plans, excluding Dental Savings Plus. NCFlex MetLife Triple Options Booklet and FAQs. Fitness: Gym and online experience discounts, Hearing & Vision: Save on eye and hearing exams, vision products and hearing aids, Home & Family: Find deals on vitamins, health supplies and wellness products, Nutrition: Enjoy savings on nutrition services and products, Personal Care: Save on mindfulness-based courses and personal care products, Travel: Save on hotels, car rental and vacation activities. North Carolina State Retirees Move to Humana PPO Plan - Humana Regular (non-temp) SHRA/EHRA employees who work 20 hours per week (.5 FTE) or greater are eligible to enroll in the this plan. Read EO 278 FAQs. The vision plan's benefits are as follows: $10 Yearly Eye Exam Copay; $10 Standard Plastic Lens Copay; $150 Lenses/Contact Lens Allowance available every 12 . Enrollment Information | NC State Health Plan Behavioral Health and Chemical Dependency/ Substance Use Services. Health Benefit Coverage. You must take action to add your newborn to your health plan. To locate a provider in your area, visit the EyeMed Vision Care web site. You have questions, let us point you in the right direction! For questions regarding enrollment, eligibility or for assistance regarding the enrollment system. ET, Monday - Friday www.UHCRetiree.com/ncshp ta/O&QY*M2zamlq State Government websites value user privacy. To share comments, concerns or general feedback on specific medical or pharmacy issues. Our Vision Plans We offer two vision plans to fit your budget or vision needs. North Carolina Health Insurance Plans | Blue Cross NC Health Insurance - UNC Human Resources 3200 Atlantic AveRaleigh, NC 27604 Map Itppo.inquiries@nctreasurer.com855-859-0966, State Health Plan Policies and Procedures, An official website of the State of North Carolina, Non-Medicare Retirees Base PPO Plan (70/30), Non-Medicare Retirees Enhanced PPO Plan (80/20), Humana Group Medicare Advantage Base Plan (90/10), Humana Group Medicare Advantage Enhanced Plan (90/10), NCStatemanualreferrals@rawlingscompany.com. Contact Us View contact information for various State Health Plan vendors to address specific questions or concerns. Your Health and Wellness Resources Disease and Case Management Nutrition and Weight Management Maternity Resources Tobacco Cessation Resources Personal Health Portal Blue365 Participants in this plan can choose in-network providers or out-of-network providers. ks7*?d,BZh1K_dm*4o0oA&xf`a4kk 61vG#|J! Check out the following health and wellness resources available to State Health Plan members by clicking the boxes below! Plans, products, and services are solely and only provided by one or more Humana Entities specified on the plan, product, or service contract, not Humana Inc. Not all plans, products, and services are available in each state. To share concerns or feedback to the Board of Trustees. View Now premiums on page 9 Lower Premiums Vision Policyholder Information Claim and Provider Questions: 800-980-2965 Provider Locator In-network provider: There is no claim form. To learn more, go toView health plans. Sign up for weekly emails to receive the deals using the steps below. Administered by Humana Insurance Company. Email: hrsbenefits@ncsu.edu, Benefits, Employee Wellness and Work Life, Retirement Plans (Voluntary/Supplemental), Employee + Family (may be employee + spouse, employee + children or employee + family). A minimum one-year, initial contract period may be required for some dental and vision plans, excluding Dental Savings Plus. This plan is administered by EyeMed Vision Care. State Government websites value user privacy. For group plans, please refer to your Benefit Plan Document (Certificate of Coverage/Insurance or Summary Plan Description/Administrative Services Only) for more information on the company providing your benefits. Or use the chat tool to chat with us online. For group plans, please refer to your Benefit Plan Document (Certificate of Coverage/Insurance or Summary Plan Description/Administrative Services Only) for more information on the company providing your benefits. Find and view primary care providers (PCPs) and health plans, Tips for choosing a primary care provider (PCP), Choose a health plan and primary care provider (PCP), Some services may require a copay. The following is additional information on how specific types of fraud complaints or cases of suspected fraud can be submitted to state agencies. Primary Care Provider Tobacco Cessation Counseling. Visual aids are the manual correction of diminished eyesight, by way of lenses (ophthalmic eyeglass frames and lenses and medically necessary contact lenses) provided by ophthalmologists, optometrists, and opticians within their scope of practice as defined by North Carolina state laws (NCGS 90-127.3 and 21 NCAC 42E). For more information, please see theAdding Dependentssection of your plans Benefits Booklet, speak with your Health Benefits Representative or call the Eligbility and Enrollment Support Center at 855-859-0966. Changes made in the online enrollment system by the 10th of the month should be reflected in the next payroll. Forexample, if your last day of work is March 20, your coverage would end on March 31. The NCFlex Vision Plan offers three plan levels of benefits. Fax: 919-513-2528 Enroll Online | Download Enrollment Form | Chat | call 855-627-3847. EyeMed State of NC Member FAQs. North Carolina State Health Plan. State Government websites value user privacy. Association membership and fees may be required on some plans in some states. View plan provisions or check with your sales representative. This plan is administered by EyeMed Vision Care. Federal law prohibits the Plan from using your personal health information to discriminate against you in any way or from giving this information to your employing agency/school or other unauthorized third party, unless required by law. NCFlex | NC Office of Human Resources View Now Learn about how UnitedHealthcare's vision plan protects your vision health: benefit explanation, premiums, how to file a claim and how to enroll. Get a quote Review available plans Note: Limitations and exclusions may apply Looking for something else? The State Health Plan is self-insured and exempt from the Employee Retirement Income Security Act (ERISA) as a government-sponsored plan. For details, please go to the Plan Overview page and view your plans Preventive Medical Services Summary or Preventive Medications List. Payment may include an administration fee. Benefits and Wellness | NCDHHS Refer to the plan documents for complete details of coverage. Not available with all Humana health plans. Check out the following health and wellness resources available to State Health Plan members by clicking the boxes below! For New Mexico residents: Insured by Humana Insurance Company. NC State Health Plan Network or go out-of-network. Before applying for group coverage, please refer to the pre-enrollment disclosures for a description of plan provisions which may exclude, limit, reduce, modify or terminate your coverage. Humana individual dental and vision plans are insured or offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., CompBenefits Insurance Company, CompBenefits Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Benefit Plan of Louisiana, Inc., or DentiCare, Inc. (DBA CompBenefits). Disease and Case Management servicesare available for members with chronic obstructive pulmonary disease (COPD), congestive heart failure, coronary artery disease, diabetes, asthma, cerebrovascular disease and peripheral artery disease. If the employee applies for health insurance after the (30) day period, there may be a 12-month waiting period for pre- . 2711 Sullivan Drive Member identification card: Please see below for examples of the 2021 member identification card for North Carolina State Health Plan retirees. You will be logged in to the online enrollment system. In states, and for products where applicable, the premium may include a $1 administrative fee. You can expect to pay an initial copay or coinsurance cost for your first pregnancy visit (diagnostic visit), or first visit, however, visits thereafter will be covered at no charge. About this website: This website describes benefits offered through the North Carolina Retirement Systems. Vision - NC State Human Resources Who We Are. Families who make too much money to qualify for Medicaid but too little to afford rising health insurance premiums can get free or reduced-price comprehensive health care for their children through the North Carolina Health Choice for Children program. Get a quote now. Both NC State Health Plan Network providers and current Blue Options PPO providers will be included in the NC State Health Plan Network as of January 1, 2020. Individual applications are subject to eligibility requirements. State Health Plan c/o BCBSNC Appeals Department. (This fee is non-refundable as allowed by state). This page includes resources to help you understand your plan options and how to enroll in benefits. During Open Enrollment or when enrolling within 30 days of being first eligible, State Health Plan members will need to attest that they do not use tobacco or will commit to visit a Primary Care Provider (PCP) who offers counseling for at least one tobacco cessation counseling session within 60 days after the last day of Open Enrollment or from their initial hire date, or risk losing their premium credit. Once in Blue Connect, click Wellness at the top of the page. Health Benefit Representative (HBR) Inquiries, For general questions for the Plan from HBRs. 1-855-202-4081 (TTY: 711). Humana group medical plans are offered by Humana Medical Plan, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Health Plan of Ohio, Inc., Humana Health Plans of Puerto Rico, Inc. License # 00235-0008, Humana Wisconsin Health Organization Insurance Corporation, or Humana Health Plan of Texas, Inc., or insured by Humana Health Insurance Company of Florida, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Insurance Company, Humana Insurance Company of Kentucky, or Humana Insurance of Puerto Rico, Inc. License # 00187-0009, or administered by Humana Insurance Company or Humana Health Plan, Inc. For Arizona residents, plans are offered by Humana Health Plan, Inc. or insured by Humana Insurance Company. Go365 is not an insurance product. To appeal a claim decision or to file a grievance. Humana group vision plans are offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Health Benefit Plan of Louisiana, Humana Insurance Company of Kentucky, Humana Insurance Company of New York, CompBenefits Insurance Company, CompBenefits Company, or The Dental Concern, Inc. New Mexico: Humana group dental and vision plans are insured by Humana Insurance Company. ORBIT - MyNCRetirement Administered by Humana Insurance Company. The NCFlex Vision plan gives you 3 options Core Wellness is offered at no cost to all state employees eligible for NCFlex, it covers an annual eye exam for the employee with a $20 copay and includes discounts on materials Humana group dental plans are offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., Humana Medical Plan of Utah, Humana Health Benefit Plan of Louisiana, Inc., CompBenefits Company, CompBenefits Insurance Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., or DentiCare, Inc. (DBA CompBenefits). All of theresources offeredare provided as part of your State Health Plan benefit and are free or provided at a low cost to you as a State Health Plan member. Humana Individual dental and vision plans are insured or offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., CompBenefits Insurance Company, CompBenefits Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc. or Humana Health Benefit Plan of Louisiana, Inc. Discount plans offered by HumanaDental Insurance Company or Humana Insurance Company. Learn more and enroll: The Basic Plan provides an annual comprehensive eye exam and a choice of eyeglass lenses or contact lenses ($120 allowance) once every 12 months, per covered person, and frames ($125 allowance) once every 24 months, per covered person. Find an eye doctor Learn more about the different types of insurance. NC is the Plan's third-party administrator for the North Carolina State Health Plan Network. PDF A Consumer'S Guide to Health Insurance Continuation Rights The website is maintained outside of New York state and the insurer is not authorized to transact the business of insurance in New York. Explore health plans for your family, including short-term gap coverage and more. medical, dental, or vision plan. Home. A lock icon or https:// means youve safely connected to the official website. Retiree Health Benefits | My NC Retirement NC State University offers health insurance to eligible faculty/staff (SHRA/EHRA employees) who work at least 30 hours per week (.75 FTE), and who work . To initiate a prior authorization request of your prescription drugs. Regular (non-temp) SHRA/EHRA employees who work 20 hours per week (.5 FTE) or greater are eligible to enroll in the this plan. *The University pays the premium for BCBSNC and the fee for NC State Student Health Center. A lock icon or https:// means youve safely connected to the official website. To get started, click on eBenefits. The Plan's objective is to recover medical expenditures incurred by the Plan where a third party is liable for the care. Your Health & Wellness Resources | NC State Health Plan If you need help finding the right person to talk to, contact NCFLEX. Base PPO Plan (70/30) & Enhanced PPO Plan (80/20) Members, Appeals & Grievances (Blue Cross & Blue Shield of NC). Non-Medicare Retirees Base PPO Plan (70/30), Non-Medicare Retirees Enhanced PPO Plan (80/20), Humana Group Medicare Advantage Base Plan (90/10), Humana Group Medicare Advantage Enhanced Plan (90/10), Required Documentation for Qualifying Life Events & Dependent Eligibility. Creditable Service. Medicareeligible retirees of North Carolina State Health Plan will move to the Humana Medicare (Group) Preferred Provider Organization (PPO) plan for their healthcare coverage, effective Jan. 1, 2021. The preventive care that is recommended for you depends on your age, sex, health history, and current health status. Vision insurance | UnitedHealthcare Please note: The rules for the termination of health coverage due to an employee's end of employment as established by 135-48.44 is as follows: . Online Monthly Seminars: Fun and interesting online seminars are available each month and focus on various health and wellness topics, such as nutrition, fitness and stress reduction. For information about Medicare, Medicare Advantage plans, Medicare claims, Medicare supplement insurance, Medicare Prescription Drug Plans, fraud and abuse prevention as well as long-term care insurance. Annual eye exam with $15 copay with an in-network provider. Employees can choose from two coverage levels: (NCFlex Vision Plan). A lock icon or https:// means youve safely connected to the official website. **Postdoc/House Officers pay by bank draft through BCBSNC for dependent coverage. If you have purchased an association plan, an association fee may also apply. A lock icon or https:// means youve safely connected to the official website. Vision Plan. For questions regarding your bill for premiums. In addition to your State Health Plan benefits, the State Health Plan strongly recommends you enroll in Medicare Part B coverage, as well as Part A, when you become eligible as a retiree, in order to maintain your same level of coverage under the State Health Plan. A one-time, non-refundable enrollment fee may apply (the fee is non-refundable as allowed by state requirements). Some health plans also offer added services. For questions regarding retirement, pension information and supplemental retirement plans. 3200 Atlantic AveRaleigh, NC 27604 Map Itppo.inquiries@nctreasurer.com855-859-0966, State Health Plan Policies and Procedures, An official website of the State of North Carolina. Patti thank you so much! Expand All Description How much does it cost? North Carolina health insurance plans | UnitedHealthcare Find North Carolina health insurance options at many price points. This communication provides a general description of certain identified insurance or non-insurance benefits provided under one or more of our health benefit plans. Human Resources Smart NC is a program provided by the NC Department of Insurance. Vision - North Carolina Retirement Systems Raleigh, NC 27695, Phone: 919-515-2151 (Service Center) (See the HDHP overview chart on page 5.) North Carolina state retirees moving to Humana PPO, Humana legal entities that offer, underwrite, administer or insure insurance products and services.