Non-Medicare Benefits & Plans



The Enhanced Care PPO (ECP) plan is the primary plan for all non-Medicare Trust members. This nationwide health plan provides unlimited Primary Care Physician (PCP) and Specialist Physician office visits, as well as other helpful programs.

More Benefits

Offered through Blue Cross Blue Shield (BCBS), the ECP plan offers greater benefits than other plan options while providing access to a national network of PPO doctors and hospitals. 

In addition to unlimited access to PCP and specialist physician office visits at a flat dollar copay, this plan features personalized, convenient resources to assist you in navigating the health care system. With this plan, you have access to a personal, dedicated health guide who can help you find hospitals and doctors, answer questions about what’s covered under the plan, assist you with any provider billing questions, as well as connect you to a supporting team of clinical staff, care managers, and new specialized programs.

Learn More About Your ECP Plan
For specific health plan information such as coverage details, participating providers, and covered preventive services, contact BCBS at 877-832-2829

- Plan Types -

It’s important to understand that the plan options available to you depend on where you live and can vary based on your Medicare enrollment. Also, keep in mind that plan options are reviewed annually to determine if they will be renewed. Often times there are yearly changes that are communicated to you in the Benefit Highlights newsletter mailed every fall.

ECP 

HMO

Enhanced Care PPO

Traditional Care Network

Eligibility

Non-Medicare Members

Eligibility

Non-Medicare (and Medicare members) living in regions within these states: California, Colorado, Georgia, Maryland, Michigan, Minnesota, Oregon, Washington D.C., Washington (state), and Virginia where an HMO is offered.

About the Plan

This is the primary plan for Non-Medicare members. Based on a nationwide network of providers, the ECP plan allows services to be performed both in-network and out-of-network.

About the Plan

While HMO plans have been a popular choice among members, they are only offered in limited areas where they are able to be competitive with the Enhanced Care PPO (ECP) plan. HMO plan options are based on a regional network of providers and do not offer out-of-network benefits (although emergency services may be covered out-of-network).

Cost

See cost share

May have copays, deductibles, coinsurance and out-of-pocket maximums.

In order to receive the highest level of benefits with the lowest out-of-pocket cost, you should receive services from an in-network provider.

Cost

See cost share

May have copays, deductibles, coinsurance and out-of-pocket maximums.

In order to receive the highest level of benefits with the lowest out-of-pocket cost, you need to receive services from an in-network provider.

For More Info

Refer to the 2019 Benefit Highlights Contact BCBS at 877-832-2829.

For More Info

Refer to your evidence of coverage or contact your HMO plan carrier at the number on the back of your medical ID card.

*To stay eligible for this plan, you must continue to pay your monthly Medicare Part B premium.

Cost Share

Before reviewing more details on your available plan options, it’s important to understand all Trust provided plans have copay and cost share elements. As a member of the Trust, you are responsible for paying certain health care coverage costs including a monthly contribution, annual deductible, coinsurance, copayment and annual out-of-pocket maximum. Understanding how these work will help you know when they apply and how much you will have to pay for care, click to view coverage costs.

Copay elements are fixed dollar amounts for services such as Primary Care Physician (PCP) office visits, specialist visits, urgent care visits and emergency room visits. Cost share elements can include deductibles, coinsurance and out-of-pocket maximums. Want more detail on what these terms mean? Visit the Health Care Glossary

 

- Benefit Materials for Download -

Below are the four main documents you will need to understand and utilize your benefits - click on the links below the images to download copies.

2019

Benefit Highlights

2019

Health Care
Benefits Summary
(Schedule of Benefits)

2015-Present

Summary Plan Description
(SPD)

2019

Plan Document

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Learn about your 2019 cost share and benefit coverage updates. An addendum to the SPD that includes year-to-year changes in cost share and benefit coverage. This is mailed to members every fall. Para español, haga clic aquí.

An addendum to SPD including current cost share and detailed coverage information on health plans, physical therapy, vision, hearing aid, dental, health programs and additional plan provisions (Benefit Highlights information is included). This is mailed to participants by request and is available online.

A summary of the Plan Document. This is written to be more easily understood and is typically updated and mailed to Trust members every five years (the current version was published in 2015). Because of this, changes made in the years between are detailed in the annual Benefit Highlights and Health Care Benefits Summary (Schedule of Benefits).Para español, haga clic aquí.

The legally required comprehensive document describing the operation and administration of the Plan. This is written using legal language and is mailed to participants by request and is available online.